Sample Reg – Gravity Form

110th Conference
Memphis, TN USA

Galvanizers Association
October 14 - 17, 2018

MEETING REGISTRATION FEE

The Delegate registration fee includes: attendance during the conference sessions; conference documentations; full breakfasts, coffee breaks, and lunches during the conference; welcome reception on Sunday, October 14th at the hotel, dinner on Monday, October 15th at the hotel, plant tour of XXXXX; offsite dinner on Tuesday October 16th; farewell lunch at the hotel on Wendesday, October 17th.

Delegate (Company is an Active or Associate Member of the GA) Fee Schedule - $700 if paid by 9/15, $800 if paid after 9/15 and before 10/11, $900 on site from October 14th.

Delegate (Company is Non-Member of the GA) Fee Schedule - $1075 if paid by 9/15, $1175 if paid after 9/15 and before 10/11, $1275 on site from October 14th.

Delegate Registration and Payment Form

Delegate Name*
First Last
Primary Phone Number*
Delegate Email Address*
Administrative Contact Email:

Please fill this in if your registering on behalf of someone
Country*
NOTE:
In order to register for the conference at the discounted association member rate, select your company (by location) from the drop down menu below*.

If you are registering for the conference as a guest, please select “Other” from the list of Company Names within the menu and proceed with registration.

*If your company is not listed in the drop down menu and you would like to join the association you can apply for membership by selecting the “Corporate Application” button at the top of page in the right hand corner. If you are from a Member Company not appearing in the drop down menu, most likely dues have not been remitted for the current year. Please contact the Galvanizers Association for resolution before attempting to register.
Company Name*
Company Name that is not on the list above

Please type your company name and ensure it is not in the list above.

Save and Continue Later

Your membership dues are NOT current. If you want to register for this years annual event at the membership rates you will need to have your Councilman of your company pay the annual dues and they will need to be received by Galvanizers Association BEFORE you are able to do so. At this time we show your company is not current on this years dues so you are only able to register at non-member rates.
Delegate Registration*
Price:
Active Member Price to register if paid after 10/16/2023
Delegate Registration Non-Member of the GA*
Price:
Delegate Registration (Non-Member of the GA) Price to register if paid after 10/16/2023
Spouse / Guest Registration*
- Not needed or will do separately
- Register Now
Select this option if you would like to register a spouse or guest. If you select this option you will be required to pay for both in the same transaction. If you need to pay this separately please navigate to the spouse registration link. Click here to go to that page
Hidden
Spouse / Guest Name
First Last
Spouse Program

The Spouse Program is full. Please contact Christa to be put on the waiting list. Phone # 810.765.4747
Hidden
Spouse / Guest Phone Number*
This cannot be the same as the Delegate. We will be reaching out directly to the spouses for menu selections.
Hidden
Spouse / Guest Email Address*

This cannot be the same as the Delegate. We will be reaching out directly to the spouses for menu selections.
Spouse / Guest Name Registration*
Price:
Spouse / Guest Registration Price to register if before after 9/15/2023 and before 10/16/2023
Special Requests

Please let us know of any special needs including dietary
Do you plan to attend the plant tour on Tuesday on Oct 30th?*
- Yes
- No
Payment*
- Pay by Paypal
- Pay by Check
We use PayPal for our credit card processing. You will have a choice to pay via your PayPal account or with a credit card when you select this option.
Round Table Choices (click on the field for choices)
Please select four table # choices in the order of preference.
Signature
Total amount due for registration
$0.00
5% processing fee for using PayPal - will be added to your total
Price: $0.00
Email
This field is for validation purposes and should be left unchanged.

Save and Continue Later

Sample Reg – Gravity Form

Delegate Registration and Payment Form

Contact info

Address