| 1. | Vendor Exhibitor? $600 Conference registration fee - discount before September 15, 2010 $1295, after September 15, 2010 $1595 One day ticket $800 - Tuesday, October 12, 2010 or Wednesday, October 13, 2010 Please note your expected dates of attendance |
$ $ |
| 2. | Please circle your Conference Dinner attendance for October 12, 2010? Yes / No No charge to attendees, guests $50. |
$ |
| 3. | Taking a short course? Yes / No Please circle your choice(s) | |
| 4. | Short course manuals can be purchased for $195 each, without attendance - circle course titles. | $ |
| 5. | Send 100 marketing items and $150 for inclusion in the Conference Proceedings. | $ |
| 6. | Unable to attend. Enclosed is $235 for a copy of the Conference Proceedings. | $ |
| 7. | Vendor spaces $300 plus conference registration fees. | $ |
| Check or PO #_______________________ payable to PACS, Inc. | $ | |
| Credit cards accepted - provide card information: number, expiration date, and name on card. | ||
| Name: | Address: |
| Company: | City / Postal Code: |
| Telephone: | E-mail: |
| http://pacslabs.com/conferences/iacc/ | |
| Print this form and mail with payment information to: | PACS, Inc. 409 Meade Drive Coraopolis, PA 15108 |
| Telephone: 1.800.367.2587 | Fax: 1.724.457.1214 |
| Website: http://pacslabs.com | E-mail: Henry at pacslabs.com |