2018 APGA Annual Conference Attendee Registration
2018 APGA Annual Conference Attendee Registration Form Name:
Spouse/Guest Name:
Children (Names & Ages):
Badge Name: Badge Name:
Company/System Name: Address:
Contact E-mail: Contact Phone:
REGISTRATION FEE:
APGA Member & Spouse/Guest @ $875 Non-Member & Spouse/Guest @ $1,275
ADDITIONAL FEES: Monday, July 23: Golf Tournament (includes box lunch & beverage cart) @ $125/person X =$ Tuesday, July 24: Chairman’s Reception & Dinner Additional Guests Note: Reception & dinner for two is included in the registration fee. The cost for additional guests to attend the reception & dinner is $100 per person. Please indicate below: @ $100/person X =$ A child’s plate may be requested for children 12 and under at no additional charge. Number of children’s plates requested: TOTAL PAYMENT ENCLOSED: $
REGISTRATION FEE: PAYMENT OPTIONS: Please make checks payable to: American Public Gas Association or APGA. Or charge the following credit card: MasterCard Visa Amex Card Number: Exp. Date: Name on Card: Security Code: Billing Address (please provide complete address including zip code):
Please complete the reverse side of this form and check all activities you plan to attend. Incomplete registration forms will be returned.
2018 APGA Annual Conference Event Selection Please check all activities you and your guest(s) plan to attend. Member
SUNDAY, JULY 22: 5:30 p.m.
Welcome Reception
8:00 a.m.
General Session (Continental breakfast with exhibitors starts at 6:30 a.m.)
1:00 p.m.
Golf Tournament ($125 per person) (Pumpkin Ridge – transportation is the responsibility of golfer)
Spouse/ Guest
Child(ren)
MONDAY, JULY 23:
8:30 a.m.
Spouses & Guests Breakfast Program
TUESDAY, JULY 24: 8:00 a.m.
General Session (Continental breakfast with exhibitors starts at 6:30 a.m.)
12:00 p.m.
Breakout Sessions: Please select ONE of the following:
8:30 a.m.
2:30 p.m.
5:30 p.m.
Spouses & Guests Breakfast 1. Operations & Safety
2. Elected & Appointed Officials 3. Past Chairmen Networking
APGA Board of Directors’ Meeting Chairman’s Reception & Dinner
NOTE: Reception & dinner for two is included in the registration fee. The cost for additional guests is $100 per person to attend the reception & dinner. A child’s plate may be requested for children 12 and under at no additional cost.
WEDNESDAY, JULY 25: 7:00 a.m.
7:30 a.m.
9:00 a.m.
Breakfast Buffet
APGA Research Foundation Board Meeting APGA Annual Meeting
Thank you for your assistance by returning both pages of your completed registration form to APGA. Send this form with payment before June 22, 2018 to: APGA | 201 Massachusetts Avenue NE, Suite C-4 | Washington, DC 20002 Faxes will be accepted ONLY if payment is made with a credit card. Fax number: (202) 464-0246 You may also register online at www.apga.org/portland Questions? Please contact Sheila Deringis at (202) 464-0832 or [email protected]
Spouse/Guest Name:
Children (Names & Ages):
Badge Name: Badge Name:
Company/System Name: Address:
Contact E-mail: Contact Phone:
REGISTRATION FEE:
APGA Member & Spouse/Guest @ $875 Non-Member & Spouse/Guest @ $1,275
ADDITIONAL FEES: Monday, July 23: Golf Tournament (includes box lunch & beverage cart) @ $125/person X =$ Tuesday, July 24: Chairman’s Reception & Dinner Additional Guests Note: Reception & dinner for two is included in the registration fee. The cost for additional guests to attend the reception & dinner is $100 per person. Please indicate below: @ $100/person X =$ A child’s plate may be requested for children 12 and under at no additional charge. Number of children’s plates requested: TOTAL PAYMENT ENCLOSED: $
REGISTRATION FEE: PAYMENT OPTIONS: Please make checks payable to: American Public Gas Association or APGA. Or charge the following credit card: MasterCard Visa Amex Card Number: Exp. Date: Name on Card: Security Code: Billing Address (please provide complete address including zip code):
Please complete the reverse side of this form and check all activities you plan to attend. Incomplete registration forms will be returned.
2018 APGA Annual Conference Event Selection Please check all activities you and your guest(s) plan to attend. Member
SUNDAY, JULY 22: 5:30 p.m.
Welcome Reception
8:00 a.m.
General Session (Continental breakfast with exhibitors starts at 6:30 a.m.)
1:00 p.m.
Golf Tournament ($125 per person) (Pumpkin Ridge – transportation is the responsibility of golfer)
Spouse/ Guest
Child(ren)
MONDAY, JULY 23:
8:30 a.m.
Spouses & Guests Breakfast Program
TUESDAY, JULY 24: 8:00 a.m.
General Session (Continental breakfast with exhibitors starts at 6:30 a.m.)
12:00 p.m.
Breakout Sessions: Please select ONE of the following:
8:30 a.m.
2:30 p.m.
5:30 p.m.
Spouses & Guests Breakfast 1. Operations & Safety
2. Elected & Appointed Officials 3. Past Chairmen Networking
APGA Board of Directors’ Meeting Chairman’s Reception & Dinner
NOTE: Reception & dinner for two is included in the registration fee. The cost for additional guests is $100 per person to attend the reception & dinner. A child’s plate may be requested for children 12 and under at no additional cost.
WEDNESDAY, JULY 25: 7:00 a.m.
7:30 a.m.
9:00 a.m.
Breakfast Buffet
APGA Research Foundation Board Meeting APGA Annual Meeting
Thank you for your assistance by returning both pages of your completed registration form to APGA. Send this form with payment before June 22, 2018 to: APGA | 201 Massachusetts Avenue NE, Suite C-4 | Washington, DC 20002 Faxes will be accepted ONLY if payment is made with a credit card. Fax number: (202) 464-0246 You may also register online at www.apga.org/portland Questions? Please contact Sheila Deringis at (202) 464-0832 or [email protected]
