Page 12 - mar-apr 2018

NPGA SOUTHEASTERN MARKETER REGISTRATION

NPGA Southeastern States Marketer Members registering at the full conference rate of $220 receive two
complimentary employee registrations. This exclusive offer provides a savings of over $440! This offer is
available exclusively to marketers within the seven southeastern host states (AL, FL, GA, MS, NC, SC, and TN).
Marketers must be a current member of the National Propane Gas Association. One individual must register at the
full conference package rate of $220 to receive the two complimentary employee registrations. Complimentary
employee registrations include access to all three show days. Complimentary employee registrations must be used
by an employee of the member company located within the southeastern states.
All forms due Friday, March 30, 2018; pre-registration is required for this discount.

PRIMARY REGISTRANT:

First Name: Last Name:
Marketer Member Company:
Title:
Address:
City: State: Zip Code:
Phone: Fax:
Email (registration confirmation will be sent to this email address):

COMPLIMENTARY EMPLOYEE REGISTRANTS (ALL FIELDS REQUIRED):

1. First Name: Last Name:
Title: Email:
2. First Name: Last Name:
Title: Email:
PAYENT INFORMATION:

Payment Amount: $220 (includes one full conference registration and two complimentary employee registrations)
 Check (payable to National Propane Gas Association) Check Number:
 Credit Card  American Express  MasterCard  Visa
Credit Card Number: Expiration Date:
Credit Card Holder:
Signature:
Signature authorizes National Propane Gas Association to charge the amount due.

SUBMIT COMPLETED FORM TO NPGA BY MARCH 30, 2018
EMAIL: registration@npga.org

12 Alabama Propane Gas Association | March / April 2018