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2013 Midyear Meeting

May 2-4, 2013
Wyndham Lake Buena Vista
Orlando, Florida
* Fields marked with an asterisk are required.
  I am an AJA Member                         I am not an AJA Member
 I am a new AJA Member
 This is my first AJA Meeting.
First Name*
    M.I. 
Last Name*
Indicate how you want your nametag to read, if different than above:
Court*
Title*
Address *
City *
State *
Zip Code *
Country*
Phone*
(111-111-1111)
Fax
(111-111-1111)
Email *
Please indicate any physical or dietary needs that require special attention:
Full name of attending Guest/Spouse

Social Functions
The information provided below will be used to plan and guarantee the number of attendees for the social functions. Once you have submitted the registration form and have to make any changes to your selections, please contact AJA as soon as possible. Inaccurate guarantees may make it difficult or impossible to accommodate all who plan to attend.
    Participant
Yes  No
Guest/Spouse
Yes  No
  Continental Breakfast (Friday)        
  Luncheon (Friday)        
  Reception (Friday - not included in special Florida Judge Fee)         

Registration Fees
 $195 Judges
 $90 Florida Judges* (Friday only – includes breaks, lunch and session materials) 
      $25.00 additional fee for 'Friday-only' Florida judges to attend reception
 $100 Guest/Spouse Fee
 I would like to join AJA ($150 for one year)
TOTAL DUE: $
*Non-member Florida judges will receive a one-year free membership in AJA.

* Payment Information: 
 Charge $ to my MasterCard
 
 Charge $ to my Visa
 
 Charge $ to my Discover
 
 Credit Card Number:  (1111111111111111)
 
 Expiration Date:  /
 
Security Code:  (3 digit code on back of card)
 
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