registration form - smps.org · registration form return this completed form with payment to build...

Registration FormReturn this completed form with payment to Build Business, SMPS, 123 N. Pitt Street, Suite 400, Alexandria, VA 22314. or Email: denise@smps.org Fax: 703.549.2498

First Time AttendeeSMPS Member #

Postal Code

Attendee Information

Please provide us with the following information.

First Name Last Name

Badge Name

Title Company

Address

City State/Prov.

E-mail Phone

Full Virtual Conference Registration

Member

$399 $599

VisaCheck Payment Type

Credit Card #

Expiration Date

Name as it appears on Card

Cardholder Signature

*Team Discount of $90 applies to three or more attendees from the same firm registering for the full conference. Team registration forms and payments must arrive together at SMPS. **Chapter Team Discount of $90 applies to two to five attendees from the same chapter registering for the full conference. Team registration forms and payments must arrive together at SMPS. ***Only one discount is allowed per registration.

Conference Cancellation-Since all conference sessions, roundtables and programming will be available for viewing after the live event, registration fees are non-refundable, and substitutions are not allowed.

MC Amex

Please add dashes or spaces: XXXX-XXXX-XXXX-XXXX

Security Code Billing Zip

Nonmember

Registration Rates

Payment Summary

Payment must accompany registration form.

Registration Fee

Team Discount* -

Team Name

Total

Only one discount is allowed per registration.