TRENCHLESS TECHNOLOGY SEMINAR "Trenchless Technology, SSES and Buried Asset Management" Edgewater Beach & Golf Resort, Panama City Beach, FL June 2nd & 3rd, 2010 Attendee, Exhibitor or Food Sponsor Registration Form

Name:
Badge Name:
Job Title:
Company:
Address:
City:	State:
Zip/Postal Code:
Phone:
Fax:
Cell Phone:
E-Mail Address:
REQUIRED

ATTENDEE REGISRATION FEES: If registering additional attendees or exhibitors, please re-submit information for each.
ITEM	QUAN	TOTAL
One Person Attendee Fee Includes: attendance, program materials, refreshments, breakfasts, lunches, reception and demonstrations: $245.00/person
Multiple Persons Attendee Fee: registering from the same organization at the same time (includes all above): $195/person
Special Fee: ASCE Members): $175/person
OTHER REGISRATION FEES:
Exhibit Table 30"x72": Includes the table, program materials, refreshments, breakfasts, lunches, reception and demonstrations for one person attending the seminar and exhibiting: $575.00/table
Food Sponsorship: Includes the advertisement, the recognition and the signage for the sponsoring of continental breakfasts, breaks, lunches or the reception with one person allowed per Food Sponsorship at the seminar in this cost: $550/Food Sponsor
Extra Exhibitor or Food Sponsorship People: Includes program materials, refreshments, breakfasts, lunches, reception and demonstrations for any extra people exhibiting or sponsor in: $100/person.
	TOTAL

You must select one of the following. If using an Invoice or PO please enter that number. Please Bill my:   Invoice PO Number Card Number:       Exp. Date: 06/10 07/10 08/10 09/10 10/10 11/10 12/10 01/11 02/11 03/11 04/11 05/11 06/11 07/11 08/11 09/11 10/11 11/11 12/11 01/12 02/12 03/12 04/12 05/12 06/12 07/12 08/12 09/12 10/12 11/12 12/12 01/13 02/13 03/13 04/13 05/13 06/13 07/13 08/13 09/13 10/13 11/13 12/13 01/14 02/14 03/14 04/14 05/14 06/14 07/14 08/14 09/14 10/14 11/14 12/14 01/15 02/15 03/15 04/15 05/15 06/15 07/15 08/15 09/15 10/15 11/15 12/15 Credit Card Zip Code Cardholder Name:

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