Missouri State Convention 2024
“Connecting with Love, Unity and Service”
August 2nd  thru the  4th

 
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Please complete this form for registration. Online payment will be completed thru PayPal. A transaction fee of 3.50% plus 49¢ for the first person and 3.50% for each additional person will be added to your registration total. Your registration package will be waiting upon your arrival. Registration and payment confirmation will be sent to you via email. For Questions please contact us through our "Contact Us" page. We look forward to seeing you there.

If you are registering for more than one person
please make sure the credit card information
matches the contact information entered on this page.
If you are using another credit/debit card the payment information may be changed when you are transfered to the paypal site.
Registration and Credit/Debit Card Information
Email:
First Name:
Last Name:
Address:
Apt or Suite:
City:
State:
Zip Code:
Phone:
First name and Last Initial will be on the name badges
fill out nickname ONLY if you want something different
Nickname on badge:
I am an   AA Al-Anon    Member
 
How many people are included in this registration (max 4)?
You will add their info on the next page.
One     Two     Three     Four    
 
 
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