2012 National Convention Registration

ENTER YOUR PERSONAL INFORMATION:

First Name

Last Name

APIC #

Email Address

Telephone

Country

Street

Unit

City

State/Province

Postal Code

ENTER NAMES OF ALL OTHER FAMILY MEMBERS ATTENDING CONVENTION:

(do not include yourself in this list)

Family Member 1

Family Member 2

Family Member 3

Family Member 4

CONVENTION REGISTRATION:

This includes admission to (a) the bourse (b) most events (c) all receptions.
Note that children 5 and under are FREE to all events except Sat meals. Names of children need to be registered.

Family (Household) Registration:

(includes APIC Member & household members attending convention)

Cost: $45.00

Quantity

Total Cost

APIC Member Registration:

(no family members will be attending the convention)

Cost: $30.00

Quantity

Total Cost

Coupon Book - includes 1-year membership to the APIC ($38 value):

(plus discounts offered by dealers at the convention)

Cost $50.00

Quantity

Total Cost

SATURDAY AUGUST 4TH EVENTS:

(enter the total number of tickets required - one for yourself and one for each family member)

Awards Breakfast:

Cost $20.00

Quantity

Total Cost

Schmidt's Dinner and State House Tour:

Cost $25.00

Quantity

Total Cost

DEALER BOURSE TABLES & LOCKING DISPLAY CASES:

Important Note: if you are renting tables or cases, you must read the Table Agreement Form available on the Convention webpage. By renting tables or cases, you are agreeing to the terms and conditions of the Table Agreement Form.

All tables are 6 feet by 2.5 feet (72 inches by 30 inches).
Please complete & sign the separate Table Agreement Form and submit that form along with this form.
Bourse tables are available for APIC members only and are available on a first come, first serve basis.
The deadline for tables and cases is July 1st 2012. Late reservations accepted if space exists.
Dealers may bring ONE assistant into the bourse during the setup time only if the assistant is an APIC member and has a paid Convention Registration.

Wall Tables inside Ballroom:

$90.00 Each

Quantity

Total Cost

Interior Tables inside Ballroom:

$75.00 Each

Quantity

Total Cost

Interior Tables inside Pavilion (close to exhibits & auction):

$75.00 Each

Quantity

Total Cost

Foyer Tables (outside of bourse convention hall):

$100.00 Each

Quantity

Total Cost

Locked Display Cases (22" x 33" x 3"):

$15.00 Each

Quantity

Total Cost

Grand Total Amount:

PAYMENT INSTRUCTIONS:

Method of payment*

Make sure you have entered correct information above. Note that any future changes to your on-line reservation must be made with the Registration Chairperson. Changes cannot be made on-line.

Click on the Submit Convention Registration link below and read the instructions that follow.