<p> 2017 MSAE Fall Conference Executive Registration Form Wednesday, October 4 – Friday, October 6, 2017 Lake Terrace Convention Center – Hattiesburg, MS</p><p>Name: ______</p><p>Organization: ______</p><p>Phone: ______Email: ______</p><p>Executive Member Registration Fees:</p><p>_____ $150 Executive Member, First Staff Registered </p><p>_____ $100 Additional Staff Member, Same Organization </p><p>_____ $100 First-Time MSAE Conference Attendee </p><p>_____ $150 Spouse or Guest </p><p>_____ $225 Non-Member (Association Executive)</p><p>_____ $25 Optional Hands-on Social Media Intermediate & Advanced Workshop</p><p>$_____ TOTAL DUE</p><p>Additional Staff / Guest</p><p>Name______Email______$25 Optional Hands-on Social Media Intermediate & Advanced Workshop</p><p>Name______Email______$25 Optional Hands-on Social Media Intermediate & Advanced Workshop</p><p>Name______Email______$25 Optional Hands-on Social Media Intermediate & Advanced Workshop</p><p>Return registration form via mail or email by September 20, 2017 to receive early registration rate. All registrations after September 20, 2017 will incur a $50 late fee. [email protected], P. O. Box 12467,Jackson, MS 39236 Credit Card Payments: received at www.msae-net.org or onsite Checks may be mailed to P. O. Box 12467, Jackson, MS 39236</p>