secure.onehundredmiles.org | Coastal Conservation in Action: Choosing to Lead Conference

Coastal Conservation in Action: Choosing to Lead Conference

Join us for our 2nd annual coastal leadership conference on January 13-14, 2018!

Register below if attending the full conference (BOTH Saturday and Sunday). Click here if you want to register for Saturday ONLY.

Please complete all fields in full. If you have questions about your registration, call 912-264-4111.

Contributor

country

first name

last name

address

city

state/region/province

zip

email address

phone number

Full Conference Registration (Sat and Sun)

	x $75.00 Member Adult Includes Saturday conference for current OHM member.
	x $100.00 Nonmember Adult Includes Saturday conference, plus a 1-year, tax-deductible $25 OHM membership.
	x $50.00 Student Includes Saturday conference for current high school or college student and a 1-year student membership to OHM.
	x $110.00 Member Adult - Saturday and Sunday Includes Saturday conference and Sunday field trip for current OHM member.
	x $135.00 Nonmember Adult - Saturday and Sunday Includes Saturday conference and Sunday field trip, plus a 1-year, tax-deductible $25 membership to One Hundred Miles.
	x $75.00 Student - Saturday and Sunday Includes Saturday conference and Sunday field trip for current high school or college student and a 1-year student membership to One Hundred Miles.
Yes! I'd also like to make a donation to the scholarship fund ($50=1 scholarship.)$

Credit Card

American Express Discover MasterCard Visa

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expiration

Attendee Information

Please list first and last names for all conference attendees.

If representing an organization, please list your title(s) and organization name.

Please select your Sunday field trip.

If you are registering more than one person and want to select different field trips, list name and field trip for each attendee below.)

Please select lunch option.

If registering multiple people, please list entree selections and quantities below.

Do you plan to attend the One Hundred Miles 100 reception Saturday evening?