To register, complete the on-line registration form below and provide interaccount information or mail a check, payable to the Kentucky State Treasurer, to: KLTPRC Conference, PO Box 4817, Frankfort, Kentucky 40604. Alternatively, you can print a PDF version of the registration form, copy as many times as needed, and mail the registration form to KLTPRC at the PO Box listed above with a check or money order made payable to the Kentucky State Treasurer, or fax it to 502-564-1412 or 800-383-1412, along with your interaccount information. DO NOT PRINT THIS PAGE as it will not print correctly.  Printable version

The early registration fee will be $50 or you may register at the door for $60.

We also offer a special Student Rate of $10, a Group Rate of 1 registration free with 4 paid registrations, and scholarships.

You will need Adobe Acrobat Reader installed to be able to view and print the registration form in PDF. If you do not have a copy of Adobe Acrobat Reader, click on the icon below.

If you prefer you may print out the registration form and fax to 502/564-1412 or outside Frankfort 800/383-1412.

Otherwise, please complete the following online form.
 

Please read our cancellation, refund and substitution policies.

Personal Information for Registration (* denotes required fields) *Title (Mr./Ms./Dr./Sen./Rep./Rev., etc.)   *First Name:   *Last Name:   *Organization:   *Address:   *City:   *State/Province:   *ZIP Code:  - *Telephone:  (Area Code/Number)  / Fax: / *E-mail:   Conference Registration (choose one) Group Rates (register 4 and the 5th attends free) and a limited number of scholarships are available. Fees below include registration for all sessions, continental breakfast, lunch, and refreshments. Registration after November 6, 2006 — $60 Student Registration  — $10 Group Rate 5th attendee  — Free      To confirm eligibility, please provide names of the four paid registrations: 1.  2. 3.  4. To better assist us in scheduling, please choose the TWO CONCURRENT SESSIONS that you would most likely attend:   Choose One Aging Population & Fraying Benefits Agriculture Broadband & Technology Economy Education Environment & Energy Health Immigation & Demographics                                                                                                                               Choose One Aging Population & Fraying Benefits Agriculture Broadband & Technology Economy Education Environment & Energy Health Immigation & Demographics   *Payment Method (You MUST indicate a payment method to complete registration.)                              Choose One Check Credit Card eMARS    Please also complete the appropriate section below. Check #    (Note:  Please mail check to the address below.) Credit cards will also be accepted this year.  If you would like to pay by credit card, please check the box below AND either (1) call us at 564-2851 or 1-800-853-2851 and ask for a credit card form to be mailed to you or (2) print out the registration form and fill in the credit card information in the space provided, then fax or mail it to our office.   I would like to pay by credit card. I will either call for a credit card form or print the registration form and send it to you with my credit card information. We can accept Visa, Master Card, Discover, and American Express.   State Government Only: eMARS # eMARS Contact Name: eMARS Contact Phone Number: Please describe any special needs (Dietary or Other): the form

Cancellation, Refund and Substitution Policies
Refunds will be made for all cancellations received in writing by November 6, 2006.  No refunds will be made after that date. Substitutions may be made at any time without penalty.  "No shows" will be charged the full registration price.