Texas Ag Industries Association

Telephone: 979/968-5602 Fax: 979/968-5624

Mailing Address: 145 W. Travis La Grange, TX 78945

Electronic mail: taia@txag.net

First Name        Last Name
Company
Address
City    State     Zip
Contact Number Email

   Sponsorship $200 (Includes Registration)
   Registration Fee $50 (Includes Family)
        Bill Me (Select this option to pay by credit card)
        Check (Please mail to TAIA 145 W. Travis La Grange, TX 78945)

   i.e. spouse, children
   Guest
   Guest
   Guest
   Guest

Events Attending
Wednesday night reception Yes No How Many
Thursday night barbeque     Yes No How Many

The above is just an estimation to help us better serve you, it is not binding but please inform us of changes.