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FA <br />FLORIDA <br />ASSOCIATION OF <br />COUNTIES <br />All About Florida <br />REGISTRATION FORM <br />FAC 2014-15 Legislative Conference <br />November 19-21, 2014 <br />Marriott Tampa Waterside (Hillsborough County) <br />FIRST NAME: LAST NAME: <br />FIRST NAME/NICKNAME (to appear on badge): <br />COUNTY/COMPANY: <br />TITLE/POS.ITION: <br />MAILING ADDRESS: <br />CITY: STATE: ZIP: <br />TELEPHONE: <br />EMAIL: <br />FAX: <br />REGISTRATION FEES: <br />Full Registration: (Commissioner/Staff)* <br />Full Registration: (City, State, Federal)* <br />Early Bird <br />(Postmarked on <br />or before Oct. 17) <br />$250 <br />$300 <br />Guest Registration: (Spouse/Non-Business Guest/Children 18+)** $100 <br />Registration <br />(Postmarked Oct. 18 <br />thru Nov. 5) <br />$275 <br />$325 <br />$100 <br />Final Registration Onsite <br />(Postmarked Nov. 6 (After Nov. 14) <br />thru Nov. 14) <br />$325 $375 <br />$375 $425 <br />$125 $150 <br />*Full Registrations include all committee meetings, New Commissioner Orientation (Wed), breakfasts, Thursday lunch, and receptions. <br />It does NOT include the Post -Conference Ethics Workshop (Friday). <br />**Guest Registrations include all committee meetings, breakfasts, Thursday luncheon, and receptions for a spouse, non -business <br />guest or child 18 years of age or older. <br />MAIL REGISTRATION FORM AND CHECK TO: <br />Florida Association of Counties <br />100 South Monroe Street, Tallahassee, FL 32301 <br />PHONE: (850) 922-4300 <br />SPECIAL NEEDS: If you are physically challenged and require special services, please attach a written description to this form. <br />CANCELLATIONS: Refund of the conference registration fee, less an administrative fee of $50, will be allowed provided written <br />or faxed notice of cancellation is sent to Connie Osborn (cosbornefl-counties.com) on or before November 13, 2014. No refunds <br />will be considered after November 13. No telephone or verbal cancellations will be accepted. <br />56 <br />