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"ARCHway to Waterproofing &
Structural Repair Opportunities"

2008 CONVENTION REGISTRATION FORM
St. Louis, MO
August 26-29, 2008

REGISTRATION

The registration form provided below is for online registration and credit card payment. If paying by Check an/or you prefer to mail in your registation please download and use our MAIL-IN REGISTRATION

Today's Date:

08/28/2008

COMPANY INFORMATION

Company Name:

Address:

City:

State:

Zip:

If non-U.S., please enter country:

Telephone:

Fax:

E-Mail:

Confirm E-Mail:

REGISTRANT INFORMATION
Only registrants admitted to educational programs (Seminars and roundtables)

Primary Company Member:

Spouse / Guest:

Additional Company Members

Additional Company Member Guests

Check which Certification Seminars you will be attending:

CWS CSRS CAWS

REGISTRATION FEES
use CALCULATOR to figure costs		Cost	Number	Total
Member:	Primary Company Member	$350.00	1	$350.00
	Additional Company Members	$300.00		$
	Spouse / Guest	$150.00		$
	"ONE DAY" Company Members	$150.00		$
	Meeting Credits Applied:	- $
	Non-Members:	Check if non-member	$795.00		$795.00
TOTAL AMOUNT PAID		$

PAYMENT INFORMATION

Name on Credit Card:

Type of Credit Card:

Credit Card Number:

Card Verification Number:

Expiration Date:

Amount of Payment:

Billing address (where you receive your credit card bills),
if different from above

Street:

City:

State:

Zip Code:

This document will not be "signed" in the sense of a traditional paper document. To verify the contents of this form, the signatory must enter any combination of alpha/numeric characters that has been specifically adopted to serve the function of their legal signature.

Pursuant to the Federal Electronic Signatures in Global and National Commerce Act and applicable state laws, I consent to the NAWSRC's use and reliance on my electronic signature to verify the information that I have provided herein.

Signature: Date: 08/28/2008

The NAWSRC reserves the right to make changes to the amount charged to your credit card in the event of miscalculation.
Cancellations: All cancellations must be received in writing on or before August 1, 2008. A $50 processing fee will be charged against each cancellation. All refunds will be processed after the convention. No refunds will be made for no shows or cancellations after August 1, 2008.
For further information please call 410-931-3332 or email us at NAWSRC@ManagementAlliance.com

I Agree

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