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

"*" indicates required fields

Delegate Name*

First Last

Primary Phone Number*

Delegate Email Address*

Administrative Contact Email:

Please fill this in if your registering on behalf of someone

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.

Country*

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

Delegate Registration Non-Member of the GA*

Price:

Delegate Registration Member Price to register

Spouse / Guest Registration*

Not needed or will do seperately

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

Spouse / Guest Name*

First Last

Spouse / Guest Phone Number*

This cannot be the same as the Delegate. We will be reaching out directly to the spouses for menu selections.

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 paid before 10/16/2024

Special Requests

Please let us know of any special needs including dietary

Do you plan to attend the plant tour on Tuesday on Oct 22nd?*

Yes

After Party on Tuesday 10/22/2024*

Yes

Will you be attending the 'Galvanizers After Glow' event at Velocity Sports on Tuesday night? Buses will run back to the hotel from the end of dinner until 11 pm.

Payment*

Pay by Credit Card or 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

5% processing fee for using PayPal - will be added to your total

Price: $0.00

Comments

This field is for validation purposes and should be left unchanged.

Sample Reg – Gravity Form

Delegate Registration and Payment Form

Contact info

Address