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2012 Convention Registration Form
* Asterisk indicates required field
*Last Name:
*First Name:
*Email:
*Telephone:
*Select Registration Type:
One Day Registration: $295
Includes keynote speaker presentation
Three Day Registration: $495
                      Gold Star Members
                check box for 15% discount
Yes, I Am A Gold Seal Menber
*Select Banquet Type:
Beef Lovers Banquet: $49.99
Chicken Lovers Banquet: $39.99
Veggie Lovers Banquet: $29.99
No Thank You, Not At This Time
*Select Extra Activities:
Bears vs Steelers: $249.99
Alder's Planetarium: $199.99
Tour Chicago Theaters: $299.99
Please indicate any special needs or accommodations needed.
Registration Fee:
Banquet Cost:
Activities Fees:
Subtotal:
Discount:
Total:
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