Register  For   LASCYPAA  28  

On-Site Registration Fee:   $15.00 at the Door *

Pre-Registration Fee:   $10.00 mailed to the address below *
      LASCYPAA
      2561 City Place Court, Suite 750-265
      Baton Rouge, Louisiana
      70808


Please include the foolowing information:
      Name
      Street Address
      City, State, Zip
      Email Address
      Phone Number
      Sobriety Date
      Do you want to be on the email list?
      Do you want to sponsor a newcomer?
      Total $ enclosed

      * Please make all checks or money orders payable to LASCYPAA.