2016 Winter Legislative Meeting Registration Form SIGMA Winter ...

Report 5 Downloads 65 Views
2016 Winter Legislative Meeting Registration Form SIGMA Winter Legislative Meeting January 22, 2016* Denver, CO * NOTE: New Format Only the Legislative Committee will meet – All are encouraged to attend One Day Only! Fly In and Fly Out

Fax this form to: 703-709-7007 Fax this form to: 703-709-7007 Use a separate form for each registrant the Use a separate formfrom for each company. registrant from the company. Photocopies ofform this form Photocopies of this If you require special are acceptable. are acceptable. services, please call:

Full Name: Title: Nickname for Badge: Company: Address: City:

State:

Zip:

Phone: E-Mail: Short Company Name for Badge: (Maximum 15 Characters)

REGISTRATION FEES: $75 PER PERSON Check Enclosed

Credit Card (Visa MasterCard, or American Express, only)

Card #

Expiration Date:

Signature:

Date:

703-709-7000

RETURN THIS FORM TO: SIGMA, 3930 Pender Dr. #340, Fairfax, VA 22030 Phone: 703-709-7000; Fax: 703-709-7007 REGISTER ONLINE AT: WWW.SIGMA.ORG

Hotel Information: Westin Denver International Airport Hotel 8300 Pena Boulevard Denver, CO, 80249 Phone: (303) 317-1800 Room Rate: $219 + Tax per night Hotel reservations may not be made until after July 1, 2015.

CANCELLATION POLICY: YOU MUST CANCEL BY JANUARY 4, 2016 TO RECEIVE ANY TYPE OF REFUND