Docstoc

Mid-Atlantic District

Document Sample
Mid-Atlantic District Powered By Docstoc
					                                                    Mid-Atlantic District
                                     Contest & Convention Registration Form
Name ___________________________________ eMail _______________________________________
Billing Address ________________________________________________________________________
City _________________________ State __________ ZIP _________                                       Phone ___________________
Quartet ____________________________________ Chapter ____________________________________

       •    Registrations WILL NOT be MAILED!                                                ORDER REGISTRATIONS:
       •    Pick up at the Registration Desk at the Convention
                                                                                             On-line: mad-registrations.org
       •    NO COD or phone orders accepted!
       •    Payent for the full amount MUST accompany this request.                          Mail: M-AD Registrations
       •    EARLY BIRD DISCOUNT of $5 expires 30 days prior to each                                  9013 Hedgerow Way
            contest.
                                                                                                     Baltimore, MD 21236-1919
       •    Order on-line and pick your seats!
       •    Seating chart available on-line (click on Contest Name to
            open seating chart in a new window                                                 NO PHONE OR COD ORDERS!



DISTRICT CONVENTIONS: (All seats reserved. Single Event Reserved seats available at the contest)                      QUAN $ AMT
   Spring Convention – March 15 & 16, 2013                 Sheraton Hotel, Parsippany, NJ        (Not available until October 15, 2012)

   Fall Convention – October 12 & 13, 2012 Premium Seats - $45 Before Sep 9 / $50 After)                             _____ $ _______
    Roland C. Powell Convention Center, Ocean City, MD     Regular Seats - $35 Before Sep 9 / $40 After)             _____    $ _______
                                                            Sat Jamboree Only - - - -               $25              ______ $ _______
DIVISION CONTESTS:                 (All Division Contests will be available for purchase after October 15th, 2012)

   Southern / Western Division Convention – April 26 & 27, 2013                        Hyatt Regency Hotel, Reston, VA

  Atlantic / Northern Division Convention – May 31 & June 1, 2013 Crowne Plaza Hotel, Cherry Hill, NJ
 MAD Endowment Fund Contribution - - - - - - - - - - - - - - - - - - - (Optional)                                                $ ______

[ * Early Bird Discounts expire 30 days prior to each contest. Full amount of registrations MUST accompany order

and be postmarker prior to date to earn discount. List special requests on back of form.]           TOTAL AMOUNT DUE               $_________

Cut off date for on-line and mail orders is 7 days prior to each contest. After that, purchase on-site.

PAYMENT INFORMATION:

Check # _____________ (Make payable to MID-ATLANTIC DISTRICT)                                                  Total ___________

  Credit Card:       We accept                                           [Card holders name and address must appear at top]
  Number: _______ - _______ - _______ - _______                          Exp Date: ____/_____                 Security Code: _______

  I authorize the Mid-Atlantic District to charge my credit card with amount indicated above: _____________________________
                                                                                                                Cardholder Signature

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:3
posted:9/13/2012
language:Unknown
pages:1