Last Name
  First Name
  Title
  Firm
  Address 
  Address
  City
  State
  Zip
  Phone
  Fax
  Email

Brief bio of yourself (Please limit to 700 characters)

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Description of your firm (Please limit to 700 characters)

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Will you be participating in the Wednesday Golf Outing?
(Green fees are $210 plus tax.)

Yes
No

Club Rental Needed? (Clubs are $80.)
Yes  (Left- or right-handed?  Right      Left)
No

Yes
No

Club Rental Needed? (Clubs are $80.)
Yes  (Left- or right-handed?  Right      Left)
No

Please indicate meal functions you will be attending:
Dinner Wednesday Evening
Lunch Thursday
Dinner Thursday Evening

Are you a member of HCPEA? (If so and you’ve elected to play golf on Thursday, September 30
(above), your greens fees will be compliments of HCPEA.)
Yes
No

Please add any comments that will assist us in making
your conference participation rewarding and enjoyable.