Conference Registration Form

Conference Registration

MISSISSIPPI BLACK CAUCUS OF LOCAL ELECTED OFFICIALS
2025 Summer Conference Registration Form

July 20 - 21, 2025

Location

Biloxi Visitors Center, 1050 Beach Blvd, Biloxi MS
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Number of people attending*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.
MUST BE REGISTERED BY

June 15, 2025

OR

a payment of $250.00 on-site registration plus any additional spouse/guest fees must be made.

NO REFUNDS AFTER

July 1, 2025
Select below
prevnext( X )
Spouse/Guest (Please select this box only for your spouse/guest(s) attending)
$30.00 Quantity

Registration Fee of $225 plus spouse/guest amount is enclosed with registration
$225.00

Total

$0.00
Should be Empty: