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2018 AFSA Convention Registration Form

Chateau on the Lake - October 17 - 21, 2018
415 N. State Highway 265, Branson, MO 65616

To make your hotel reservation, call the following:
Toll Free Reservations: 1-417-334-1161 (Ask for AFSA Annual Conference Group Rate)
The reservationist will offer rooms at several rates including $139.00 per night, plus tax.

(This will be the name that will be on your convention name badge.)

Registration Fees # Amount ($)
AFSA Member Registration Fee $110
Guest Registration Fee $100
Hospitality Room Non-Alcoholic Drink Preference Discount -$10
*Registration fees include: Wednesday Evening President’s Welcome Dinner; Saturday Opening Ceremony and CPE Classes; Saturday Evening Banquet Dinner; and Hospitality House Sessions.

Attending Saturday AFSA Business Meeting
Attending Saturday CPE
Attending Wednesday Evening President’s Welcome Dinner (Included in Registration Fee)
Attending Saturday Evening Banquet Dinner (Included in Registration Fee—Make your dinner selections below.)

Please indicate the activities you wish to participate in: (See convention schedule for activity details) Fees (per person) # Amount ($)
Thursday, Oct. 18 Bob Manzi Memorial Golf Outing $75
Player 1) Handicap/Avg:
Player 2) Handicap/Avg:
Friday, October 17 College of the Ozark Branson Landing/Old Town Tour and Dinner Cruise/Show $75
Total Amount Paid:

Pan Seared Chicken Breast (Paprika, Agave, Roasted Red Pepper and Risotto)
Almond Encrusted Salmon (Thyme Jasmine Rice with Amaretto Cream Sauce)
Grilled Filet Mignon (8 oz cut, Bleu Cheese, Onion Confit, Port Wine Demi-Glacé Asparagus Tip and Bacon Fingerling Potato Hash)

E-mail registration form to and mail your check to:
Gerard Dupczak
1428 Charlevoix Way
Schererville, IN 46375

For general CONVENTION INFO, please visit