Annual Conference Registration Form
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Date
Membership
Select Membership
Utility Member
Utility Non-Member
Associate Member (Basic Member)
Associate Member (Silver Superbooster)
Associate Member (Gold Superbooster)
Associate Member (Platinum Superbooster)
One Day Tuesday Registration
Connections:
Make Selection
1,000 Customers or less
More than 1,000 Customers
Technical Session Registration Fee $
per person
Registrant Name
Spouse Name
Guest/Child
Utility/Company Name
Address
City
State
Zip Code
Phone
xxx-xxx-xxxx
Fax
xxx-xxx-xxxx
E-mail
Meals
(Please provide number attending)
Meals are included with primary registrant but we need to know if you plan to attend.
$60 per person will be added for any additional.
Monday Continental Breakfast
Tuesday Associate Awards Breakfast
Tuesday Sandwich Bar
Wednesday Continental Breakfast
(For Primary Registrant Only)
Special Events & Activities
(These activities are not included in conference registration - Pricing per person)
Arrington Vineyards Tour and Mixer
(Dinner and bus transportation provided)
Before
May 16
After
May 16
Number attending:
Include everyone 6 and over
$25
$30
Number of children under 6:
Children under 6 free
$0
$0
Transportation:
I will ride the bus
I will drive myself
Not going
Ladies Social
Lillie Belle's Tea Room, Downtown Franklin Tour and Shopping
Before
May 25
After
May 25
Number attending:
$30
$35
Annual Henry Elrod Memorial Golf Tournament ($85)
Play in Golf Tournament?
I don't want to play
Yes
Shirt Size:
Select Size
x-Small
Small
Medium
Large
x-Large
xx-Large
xxx-Large
xxxx-Large
Average Score:
County Fair at the Factory
(Dinner and bus transportation provided)
Before
May 16
After
May 16
Number of Adults:
$35
$45
Number of Children:
(6 and Over)
$20
$30
Number of Children
(Under 6 are free)
$0
$0
Transportation:
I will ride the bus
I will drive myself
Not going
Attendee Listing
(Available to members only, after conference)
Yes
$
(Members Only)
Free for Superboosters
Grand Total
$
Pay By Credit Card
Pay Later
Credit Card Information
First Name
As it appears on card
Last Name
As it appears on card
Billing Address
Billing City
Billing State
Billing Zip Code
Card Type
Visa
Discover
American Express
Mastercard
Card Number
Enter number without spaces
Expiration Date
mm/yy
Amount of Payment
$
Do you want a receipt?
Yes
No
E-mail Address