Registration AMMA Scholarship Packet Alaska Municipal Management Association Annual Meeting Complete and submit this form to register for the 2023 Alaska Municipal Management Association Annual Meeting, which will take place December 4-5, 2023, at the Dena’ina Center in Anchorage. "*" indicates required fields Name* First Last Title* Municipality/Organization* Email Address* Phone*Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you an AMMA Member?* Yes No Register for the Alaska Municipal Management Association Annual Meeting - For Members Monday - Tuesday, December 4-5 - $225 Register for the Alaska Municipal Management Association Annual Meeting - For Non-Members Monday - Tuesday, December 4-5 - $250 Total Payment Options* Please invoice me I will pay online with a credit card Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name PhoneThis field is for validation purposes and should be left unchanged. Δ
