Full Name:
Mobile Fueling, Tankwagon & Cardlock Form: Sep. 29-30, 2016 – San Antonio, TX Company Name: Address: City:
State:
Zip:
Phone: E-Mail:
List all Attendees Job Title
Name
Email Address
Registration Fees
SIGMA MEMBERS
EARLY BIRD
REGULAR RATE
LATE RATE
AMOUNT
THRU JUN 30
JUL 1 – AUG 26
AFTER AUG 26
DUE
THROUGH DEC
ALL MEMBER CATEGORIES
8 FIRST REGISTRANT
$499
$599
$649
EACH ADDITIONAL REGISTRANT
$349
$399
$449
$1299
$1399
$1449
NON MEMBER/PROSPECTIVE PLEASE CONTACT [email protected] FIRST REGISTRANT
TOTAL AMOUNT DUE Check Enclosed Card # | | Signature:
| | |
Credit Card (Visa, MasterCard, or American Express, only) | |
|
| |
| | |
| |
| |
Expiration Date:
Date:
CANCELLATION POLICY: Registrations cancelled in writing: 45 days in advance (100% refund); 30-45 days in advance (75% refund); 15-29 days in advance (50% refund); less than 15 days notice (NO REFUND). SIGMA reserves the right to cancel if fewer than 12 people are registered 30 days prior to the Share Group.
State:
Zip:
Phone: E-Mail:
List all Attendees Job Title
Name
Email Address
Registration Fees
SIGMA MEMBERS
EARLY BIRD
REGULAR RATE
LATE RATE
AMOUNT
THRU JUN 30
JUL 1 – AUG 26
AFTER AUG 26
DUE
THROUGH DEC
ALL MEMBER CATEGORIES
8 FIRST REGISTRANT
$499
$599
$649
EACH ADDITIONAL REGISTRANT
$349
$399
$449
$1299
$1399
$1449
NON MEMBER/PROSPECTIVE PLEASE CONTACT [email protected] FIRST REGISTRANT
TOTAL AMOUNT DUE Check Enclosed Card # | | Signature:
| | |
Credit Card (Visa, MasterCard, or American Express, only) | |
|
| |
| | |
| |
| |
Expiration Date:
Date:
CANCELLATION POLICY: Registrations cancelled in writing: 45 days in advance (100% refund); 30-45 days in advance (75% refund); 15-29 days in advance (50% refund); less than 15 days notice (NO REFUND). SIGMA reserves the right to cancel if fewer than 12 people are registered 30 days prior to the Share Group.
