Badge Information Full Name: Title: Instructions Nickname (for badge ...
Badge Information Full Name: Title: Instructions
Nickname (for badge):
Fill out this form, using a separate form for each registrant from the company and return form to: SIGMA 3930 Pender Drive Suite 340 Fairfax, VA 22030 Fax: 703-709-7007 Email: [email protected]
Company: Short Company Name: (for badge, maximum 15 characters) Address: City:
State
Zip
State
Zip
Phone: Email:
Cancellation Policy
Attending Spouse/Guest Badge Information
All cancellations requests must be made in writing to [email protected]
Full Name: Nickname (for badge):
Requests received before January 15, 2017 will receive a full refund.
Spouse Email:
Requests received before March 1, 2017 will receive a 50% refund.
Address:
Refunds will not be issued after March 1, 2017
City: Phone:
Registration Fees
SIGMA Member Rate BEST RATE!
Early Bird Rates Until January 15
Regular Rates Until March 1
Late/Onsite Rates After March 1
$750
$900
$1050
Non-Member Rate
$3000
Non-Fuel Supplier Rate
$3000
SIGMA Strategic, Gold, or Silver Partner Rate
$1000
Spouse/Guest Fee
$300
$350
Amount Due
$400 Total Amount Due
Payment Information □ Check Enclosed
□ Credit Card (Visa, MasterCard or American Express only) Card #: Expiration Date: Signature:
Booster Signature I understand that $10 of my meeting registration fee, which cannot be deducted from the total, covers my dues as a SIGMA Booster. Signature:
Date:
Nickname (for badge):
Fill out this form, using a separate form for each registrant from the company and return form to: SIGMA 3930 Pender Drive Suite 340 Fairfax, VA 22030 Fax: 703-709-7007 Email: [email protected]
Company: Short Company Name: (for badge, maximum 15 characters) Address: City:
State
Zip
State
Zip
Phone: Email:
Cancellation Policy
Attending Spouse/Guest Badge Information
All cancellations requests must be made in writing to [email protected]
Full Name: Nickname (for badge):
Requests received before January 15, 2017 will receive a full refund.
Spouse Email:
Requests received before March 1, 2017 will receive a 50% refund.
Address:
Refunds will not be issued after March 1, 2017
City: Phone:
Registration Fees
SIGMA Member Rate BEST RATE!
Early Bird Rates Until January 15
Regular Rates Until March 1
Late/Onsite Rates After March 1
$750
$900
$1050
Non-Member Rate
$3000
Non-Fuel Supplier Rate
$3000
SIGMA Strategic, Gold, or Silver Partner Rate
$1000
Spouse/Guest Fee
$300
$350
Amount Due
$400 Total Amount Due
Payment Information □ Check Enclosed
□ Credit Card (Visa, MasterCard or American Express only) Card #: Expiration Date: Signature:
Booster Signature I understand that $10 of my meeting registration fee, which cannot be deducted from the total, covers my dues as a SIGMA Booster. Signature:
Date:
