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Welcome to ASHRAEŽ- Rockford Chapter 119
CRC 2004 Registration Form
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Use electronic form on-line at - http://www.ashraelacrosse.org


Registration Form

CRC 2004 Rockford, IL

(Please print or type)

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First Name

 

Last Name

 

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Company

 

Address

 

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State

 

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Companion Information

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Early Registration After     April 15
Complete Package  
___ Member  $         210  $        230
___ Non-Member  $         230  $        250
___ Student (Friday Tech Sessions & Lunch)  $           25  $          25
___ Companion (access to everything below)  $         125  $        135
           
 
Separate Tickets  
___ Welcome Party (Thursday)  $           45  $          50
 
___ Technical Sessions & Lunch (Friday)  $         100  $        110
___ President's Lunch (Friday)  $           25  $          30
___ Awards Lunch (Saturday)  $           25  $          30
___ Banquet (Friday)  $           50  $          55
___ Companion Tours & Lunch (Friday)  $           35  $          40
___ Companion Tours (Saturday)  $           15  $          20
 
TOTAL  $  $

 

Return this form and check to:    (Make checks payable to: Rockford CRC 2004)

 

Alpha Controls

Attn:  Bill Kushner

4104 Charles St.

Rockford, IL  61108

 

 

                                        

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