March 30, 2012 Symposium: American Energy Independence: An “all

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March 30, 2012 Symposium: American Energy Independence: An “all of the above” strategy for our energy policy

Registration Form

Please complete the following information:

NAME: _______________________________________________________________

BUSINESS OR ORGANIZATION: ________________________________________

ADDRESS: ____________________________________________________________

_______________________________________________________________________

PHONE: __________________________ EMAIL: ___________________________

Please select one of the following:

General Registrant $150 

Government or Non-Profit Employee

Law Student,

Faculty, or Staff

$75

$25

Please send completed form, along with applicable payment in the form of a check or money order to:

EELPJ

Attn: Brittany Morris-Easley

100 Law Center

Houston, TX 77204

For questions or information, please contact Brittany Morris-Easley at: [email protected]

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