Conference Registration

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Name*

Email*

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Affiliation*

Address*

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2023 LMCA Conference

Product Name

Option

$20, Student registration

$150, Early bird registration

$175, Late registration, Nov 13th – Dec 11th

$30, Guest for Pre-Banquet Social/Banquet

$20, join the LMCA

$20, LMCA Annual Membership Renewal

Payment Options*

Credit Card

Check or money order
Mail to: LMCA Registration: Louisiana Mosquito Control Association, 611 Old Central Taxiway, New Iberia, LA 70560

My registration is included in my sponsorship/vendor package

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American Express

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Card Number

Expiration Date

Security Code Cardholder Name

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