FORM: ICMA Regional Summits ALTERNATE PRICES REGISTRATION FORM

Use this form only for alternate summit options. If you want to register for the Full Regional Summit you must register online, at icma.org/summit.

Please type or print clearly. All registration forms must be accompanied by check or credit card number. ICMA cannot bill you. Please fax registrations charged to a credit card to 202-962-3678, or mail your registration and check payable to ICMA to: ICMA, PO Box 79403, Baltimore, MD 21279-0403. All fees in U.S. dollars. All cancellations must be in writing and received 5 business days before the start of attending summit/leadership institute.  Individuals will receive a full refund minus a $50 processing fee. No refund requests will be accepted after the summit/leadership institute has started.