REGISTRATION INFORMATION * requiredSalutationSelectMr.Mrs.Ms.Dr.First Name*Last Name *OFFICE / JURISDICTION *Position/Title *Number of Years With Current Office *
CONTACT INFORMATIONPhone Work: (e.g. ###-###-### x ext) *Cell Phone: (e.g. ###-###-### )E-mail: *OFFICE ADDRESSAddress 1:*Address 2:City: * State (ie: CA):* Zip code:*
CLE Participants may qualify for continuing legal education. Please check with your state bar association regarding requirements. APA will provide information regarding CLE credits at the conference.