Page 19 - Enclosure_Spring-Summer_2023

AGS CONFERENCE 2023

July 24 - 27, 2023 ~ Las Vegas, NV

Registration Form

Name Last (Surname): _____________________________________ First __________________________Middle Init. ________________

First name/Nickname for badge ______________________________ Company _______________________________________________

Company Title or Position __________________________________________________________________Company Mail Code ________

Mailing address is my  Home  Business

Mailing Address _______________________________________________________________________ City ______________________

State/Province ___________________________________ Postal/Zip Code __________________ Country _______________________

Daytime phone number: ( __________ ) _____________________ FAX number: ( __________ ) ________________________________

Email: ___________________________________________________________________________________________________________

Conference Registration

BY JUNE 26 AFTER JUNE 26
 CONFERENCE & WORKSHOP (MON. - THUR) $1050.00 $1100.00 $ _____________

Thursday Workshop Selection  Morning session (8 - 1) or  Afternoon session (1-5)
 CONFERENCE ONLY (MON. - WED.) $945.00 $995.00 $ _____________

 THURSDAY (THUR.) $295.00 $345.00 $ _____________

Thursday Workshop Selection  Morning session (8 - 1) or  Afternoon session (1-5)

Payment Information

TOTAL DUE $_______________

Payment Enclosed:  Check (Payable to “AGS”)  Credit Card (Visa/Mastercard/Amex)

CARD NUMBER: ____________________________________________________________

EXP. DATE: ______________ CVV#:__________________ BILLING ZIP ________________

Summer 2023 www.gloveboxsociety.org 19