APICS Southwest District Meeting - Phoenix, AZ
Saturday Night Event Registration

The following Saturday Night Event is available for registration. Please submit a separate registration form for each attendee.

* Late registration fees apply to Phoenix Chapter Members if registration is received after the Early Registration Deadline at 5:00 p.m. on the date noted below. Limited registrations are available for this event.

Event Date
Venue
(subject to change)
Primary Dinner Selection
Early Registration Deadline*

February 20, 2010
7:00 p.m. - 10:00 p.m.
Dave & Buster's, Tempe Marketplace
Grilled Chicken Buffet
2/14/2010
Select One: Make a Reservation Cancel a Reservation
Select the Event:
Attendee Name:
Email Address:
Representing the following APICS Chapter:
Attendee Contact Address:
City, State Zip: ,
Phone:

Dinner Selection:

Registration Type/Price:
   Member ID Required for Phoenix Chapter Membership Discount: Expiration:
    NOTE: Member ID is required or Non-member rate will be applied for Phoenix Chapter Members.

Select Payment Type:

    NOTE: Effective January 1, 2009, all Phoenix Chapter membership reservations require a Visa/Mastercard guarantee. No-shows will be billed. AMEX not accepted at this time.
    Credit Card #: Credit Card / Voucher Expires(MM/DD/YYYY):

    Membership or Discount Voucher Number:     Voucher Exp (MM/DD/YYYY):

Comments:

Cancellations must be received by the registration deadline noted above. No shows will be billed!

By submitting below I acknowledge and:

1) Agree to abide by the cancellation policy stated above.
2) Authorize the Phoenix Chapter to accept payment or charge my account as noted.
3) Authorize the Chapter to add my contact information to the Chapter's Constant Contact listing to receiving future notices regarding events. I understand that I may opt out of future noticies by unsubscribing to this service on the contact email.