2019 Southern Fall Conference Registration
Please fill out this form to register for NMRWA's 2019 Southern Fall Conference

IF YOU ARE PAYING BY:
CHECK OR PURCHASE ORDER - Please mail checks to our office at 8336 Washington Place NE, Albuquerque, NM 87113, please include name of attendee with the check to insure registration is complete.
CREDIT CARD - Please call our office at 505-884-1031 or 1-800-819-9893 to pay over the phone

First Name *
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Last Name *
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System Affiliation *
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Address
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City
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State
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Zip Code
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Phone Number
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Email Address *
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Registration Type *
Are you Registering a Spouse? *
Payment Type *
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