AttendeesPaymentPlaceholder Attendee 1 Delegate Name *This field is required. Badge Name *This field is required. Title *This field is required. Registration Type *Member WorkshopNon-Member WorkshopMember UPCS CertificationNon-Member UPCS CertificationThis field is required. Price Subtotal Additional Attendee Remove Attendee Cart Total Next Pay By Check Pay By Credit Card Payment MethodThis field is required. Primary Contact *This field is required. Agency *This field is required. Address Line 1 *This field is required. Address Line 2This field is required. City *This field is required. State *This field is required. Zip *This field is required. PhoneThis field is required. EmailThis field is required. Confirm EmailThis field is required. Submit Credit or Debit CardThis field is required. Submit Payment Cart Total Previous For questions or payments, please contact: GAHRA Registration c/o Joe Wisniewski Augusta Housing Authority 1435 Walton Way Augusta, GA 30901-2609 email: jwisniewski@augustapha.org Telephone: 706-724-3710 Fax: 706-722-4522 You will not be registered for this conference until payment is received. Checks and forms should be mailed to the address below. Make checks payable to GAHRA You have been registered for this conference.
