__________________________________________________________
First Name                                        Last Name


___________________________________________________________________
Title


___________________________________________________________________
Company


___________________________________________________________________
Mailing Address


___________________________________________________________________
City                                                                      State                  Zip


___________________________________________________________________
Phone


___________________________________________________________________
Fax


___________________________________________________________________
E-Mail


___________________________________________________________________
Grand Total
  
 
Before
July 10th
After
July 10th

Totals
MCTA - WCTA
Members (incl. 1     
person from system
& 1 spouse/guest)

$250.00

$275.00
  
Associate Members

Spouse.Additional
person(s) same
company
 $250.00


$200.00
 $275.00


$225.00
  

White Water Rafting
$75.00
$75.00
  

Golf Tournament
$75.00
$75.00
  

Yellowstone Park
Tour
$120.00
$120.00
  

Exhibitor Space
(Incl. One 6ft. Table)

$125.00

$125.00
  
2007 MCTA - WTCA Convention Registration Form
Please make check or money order payable to:
Montana Cable Telecommunications Association - (MCTA)
Tax ID #  81-0405260

Please mail registration form(s), along with payment to:
MCTA
P.O. Box 7015
Helena, MT  59604
Phone:   406-431-4754  Fax:  406-449-7659
E-Mail:   tommg3999@bresnan.net

For more information please contact:
Tom Glendenning
Phone:   406-431-4754
E-Mail:   tommg3999@bresnan.net
Advance Registration Deadline:   July 10

Convention Hotel:

Holliday Inn
315 Yellowstone Ave
West Yellowstone, MT   59758

Reservations:  800-646-7365

Room Rates:
$125.00 - 175.00

Room Block Release Date:    06-17-07
Reserve your room Today ... Don't Delay   
Montana Web Site:  www.mctamt.com  --  Wyoming Web Site:  www. wyocable.org

** Tip:   Print form, complete,  & send to MCTA at address above with check or money order