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Group Registration: ALL participants MUST complete a form with Contact Information �lled out. Only ONE payment is needed.
Registration Form
Conference Name: 2019 Administra e Professionals
Conference Conference Dates: April 24 & 25, 2019
Conference Loca : Chito Samanieg El s X
Company:
Address:
City:
State/Province:
Zip/Postal Code:
SELE DA E A ENDING:
WEDNESDAY, April 24, 2019
THURSDAY, April 25, 2019
hec payable to: i e Direc
Credit Card
American Express Mastercard Visa
Card Number:Expira ate:Cardholder Name:CSV #:Billing ip Code:
WAYS O REGIS ER:
Register ONLINE at www.apcsouthwest.com
By ax: 15.533.0828
By ail: Posi e Direc s Co.814 ming AvenueEl , X
02
PLEASE NO E: YOU ARE N REGIS ERED UN IL PAYMEN IS RECEIVED
814 Wyoming Ave. El Paso, TX 79902
Phone: 915-838-1000 Fax: 915-533-0828
www.apcsouthwest.com
Total: $945.00 Please
choose an option
Five Person Form
Invoice No.: ________________________ Date:______________________________
PO No.:_____________________________________Terms: _____________________________________Vendor No.: _________________________________
Due Upon Receipt
: ALL par ipants MUS complete a form with Group RegistrContact Inform ed out. ly NE payment is needed
REGIS RA ION FEES:Register and Pay by April 14th to secure discounted rate!After April 14th the rate is $259.00 per person
$199 Early-Bird Registration- Save $60.00 (One Person)
Group Pricing r 5 or 10 Par cipants Valid hrough Event Date
$189 per person when you buy 5 (total $945) - Save $350 (We must have 5 names, one payment)
$179 per person when you buy 10 (total $1790) - Save $800 (We must have 10 names, one payment)
All Sales Final
Participant InformationName:
Title:
Phone:
Email:
Participant InformationName:
Title:
Phone:
Email:
Participant InformationName:
Title:
Phone:
Email:
Participant InformationName:
Title:
Phone:
Email:
Participant InformationName:
Title:
Phone:
Email: