USCAFC - Judicial Conference Online Registration

	Registrant Address & Contact Information :
*Name:
Title:	*Firm:
*Address 1:
Address 2:
*City:	State: ZIP Code:
Phone:	Fax:
*E-Mail Address:	(Enter Only One Email Address)

	Breakout Sessions:
	*Session Attending:

	Registration Fees :
Fees:	CLOSED............General Registration..........................................$275
	CLOSED............Current Government Employee ..........................$225
	Late Registration (After May 2, 2008) ..........................................$295

	Credit Card Billing Information:
*Name:	(Credit Card Billing Name)
*Address 1:	(Credit Card Billing Address)
Address 2:
*City:	State: ZIP Code: (Credit Card Billing City, State, ZIP/Postal Code)
*Phone:	(Credit Card Billing Telephone Number)

	Method of Payment:
*Credit Card:
	Visa Master Card

	*Card Number: (i.e., 4111-1111-1111-1111)
	*Expiration Date: /