Registration Form

Managing Conservation Easements in Perpetuity

September 6-7, 2007

First Name: ___________________________________________________

Last Name: ___________________________________________________

Organization: __________________________________________________

Title: _______________________________________________________

Street Address: ________________________________________________

City: __________________________________________State: _________

Zipcode: ____________Email:_____________________________________

Phone: __________________________________

	Early-Bird	Regular
Day 1 (Thursday)	$30.00	$50.00
Day 2 (Friday)	$65.00	$90.00
Thursday Night Lodging	$55.00 single /$85.00 double	$75.00 single /$105.00 double

Early Bird Deadline: August 7th, 2007
Please register early to ensure lodging availability!!

I plan to attend only Day 1 (9/6) $ ________

I plan to attend only Day 2 (9/7) $ ________

I plan to attend both days $ ________

I will need overnight accomodations
(circle one): single or double $ ________
Double Only: 2nd Guest _______________________

CLE Credits ($25.00) $ ________

TOTAL $ ________

Please print and mail this form along with a check payable to:

Pennsylvania Land Trust Association
105 Locust Street, Suite 300
Harrisburg, PA 17101-1453