Conference Registration Form

 

 

Please return the completed form by mailing or faxing it to the address provided below.  
Seating capacity is limited so please register as soon as possible.

 

The conference fee is $150.00 for bankers and $75.00 for their customers. Spouses and students $25.00. 
Registration fees include all sessions, refreshments throughout the day, and lunch.
 	Name		___________________________________________________
 	Name		___________________________________________________
	Name		___________________________________________________
	Name		___________________________________________________
	
	Company	___________________________________________________
	Address     ___________________________________________________
					___________________________________________________
	Phone		____________________________________________________
	
    Registration Cost
     ___ # Lenders and Ag Service Providers @ $150 =  _______
     ___ # Farmers and Producers @ $75 =                      _______
     ___ # Spouses and Students @ $25 =                         _______

      ___ # Attending Pre-Conference Session @ $30 =   _______

                 See Pre-Session Description

    Total Registration Amount:                              _______
 

	Method of Payment (Check one)

 ____ Check (Payable to UT Martin)
 ___  Discover
 ___  Visa
 ___  Master Card
 	Credit Card No. ______________________________ Exp. Date ____________
	Signature ________________________________________________________

 

 

Submit by Mail or Fax with Payment To:  
Dr. Tom H. Payne
Dunagan Chair of Excellence in Banking
College of Business and Global Affairs
The University of Tennessee at Martin
216 Business Administration Bldg.
Martin, TN  38238

Phone: 731-881-7324
Fax:     731-881-7323
Email: tpayne@utm.edu