Price: $30 SLSA Members; $35 Non-Members ($5 extra for reservations made after the cutoff date of November 17, 2019 by 12:00 p.m.) Please use the form below to register. If you choose to pay by Pay Pal or credit card, you will be taken to Pay Pal to complete payment. Note, you can use your credit card with Pay Pal if you do not have or do not want to use a Pay Pal account. Download the flyer Dinner: Taco Bar from Cilantros, including green salad, dessert, soda and water Please fill out separate form for each attendee. Name* First Last Firm/CompanyAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* PhoneAre you interested in hearing about SLSA volunteer opportunities?YesNoTopic SuggestionGeneral CommentsCertificate requests I request a MCLE/CLE Certificate I request a CCLS Certificate Payment Method*By Pay Pal or Credit CardBy CheckPrice Options*Price includes convenience fee.Member - $31.20 (October 2019 DM)Non-Member - $36.35 (October 2019 DM)Member (After deadline) - $36.35 (October 2019 DM)Non-Member (After deadline) - $41.50 (October 2019 DM)Pay by check pricing optionsMember - $30.00Non-Member - $35.00Member (After deadline) - $35.00Non-Member (After deadline) - $40.00Are you interested in becoming a member?Yes, I am interested in becoming a memberNo, not at this timeNOTE: Cancellations must be received 48 hours in advance for a refund. No-Shows will be billed. NOTE: Cancellations must be received 48 hours in advance for a refund. No-Shows will be billed. Once you submit this form, you will be sent an e-mail that you can print and send it with your check.