MAALACT Registration
Email address *
First Name *
Your answer
Last Name *
Your answer
Institution *
Your answer
Department *
Your answer
Street Address 1 *
Your answer
Street Address 2
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Friday Night Reception and Dinner ($60 - In addition to registration) *
Please let us know of any dietary restrictions
Your answer
Please pay for your registration at MAALACT.org/meetings
Registration fee $85
Registration and Opening Dinner $145
Opening Dinner Only $60
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