Sheraton Burlington Hotel & Conference Center

870 Williston Road

South Burlington, VT 05403

Hotel Reservations 1-800-325-3535

Early registration open until August 25!

Name (Last, First, MI):
Title:
Agency/Organization:
Street Address
City/State/Zip:
Home/Cell Phone:
Work Phone:
Email:
Membership Level:
Dietary Restrictions:
Please indicate your registration selections on Page 2

Summit Registrations must be received by September 8, 2017.

After September 15, 2017 all registrations must be processed on-site.

Make checks payable to: SMSA

1434 Trim Tree Road

Indiana, PA 15701

To Pay by Credit Card Call the SMSA Office at: 724-801-8075

Please circle your registration selection(s) below

Registration Type / Early Registration
Before 8/25/17 / Registration
8/25/17 thru 9/8/17 / On-Site Registration
After 9/8/17
Members /
Federal / Non-Members / Members /
Federal / Non-Members / Members /
Federal / Non-Members
National Training Summit Registration
September 27-30 2017
(includes Range Activities) / $350 / $450 / $400 / $500 / $450 / $550
National Training Summit Registration
(1-Day only Registration)
Circle Day: Thurs Fri Sat / $125 / $175 / $150 / $200 / $175 / $225
2 Day Exhibitor Only Registration – No Sessions/Events – Meals Only / $175 / $275 / $225 / $325 / Not Available / Not Available
Spouse Registration / $200 / $250 / $200 / $250 / $250 / $300
Professional Development Workshops – Wednesday, September 27, 2017:
PDW #1 TBD
8:00 am – 11:30 am
Pre-Registration Required / Y / N
PDW #2 – TBD
1:00 pm – 5:00 pm
Pre-Registration Required / Y / N
PDW #3 – TBD
1:00 pm – 5:00 pm
Pre-Registration Required / Y / N
Summit Activities:
Tour-TBD
2017 Members Annual Business Meeting
Wednesday September 27, 2017 1:00 p.m. – 5:00 p.m. / Y / N
SMSA Newcomers Meeting (for all new/first-time SMSA attendees)
Thursday September 28, 2017 7:15 a.m. / Y / N
Join SMSA and save on your Summit Registration.

National Association of State Motorcycle Safety Administrators ● 1434 Trim Tree Road ● Indiana, PA 15701 Phone: (724) 801-8075 ● Fax: (724) 349-5042 ● ● www.smsa.org