Trade Fair Registration

NOTE: This form is for credit card registration.
For check/cash payment or assitance with registration, call Tom Tudor 909-647-5515.

Attendee Registration

Seminars: 1:00PM, 2:00PM and 3:00PM
If you plan to attend the seminars please arrive thirty minutes prior to the start time.

Trade Fair: 4:00-8:00PM, Dinner 6:00-7:30PM

Note: Select line. Seminars are limited in size.
Please indicate if you intend to attend the Seminars Trade Fair & Dinner or Trade Fair & Dinner only.

Attendee 1 Name (first & last)

Select:

Attendee 2 Name (first & last)

Select:

Attendee 3 Name (first & last)

Select:

Attendee 4 Name (first & last)

Select:

Attendee 5 Name (first & last)

Select:

Attendee 6 Name (first & last)

Select:

Scholarship Fund Donation (optional)

Since 1984, the George Epstein Scholarship Fund has helped student who are in the plastics industry. this is an optional doantion. The Southern California Society of Plastics Engineers thanks you for your consideration.

Sponsor (optional)

*Donate to the George Epstein Scholarship fund $25.00

Total Billing To Credit Card

Registration Total:

Billing Information

Company:

*Address Line-1:

Address Line-2:

*City:

*State:

*Zip Code:

*Phone:

888--888--8888

Credit/Debit Card Information

*First Name:

Same name as on your card

Middle Initial:

*Last Name:

Same name as on your card

*Card Number:

No dashes or spaces please

*Expiration Month:

From your card

*Expiration Year:

From your card

*Card Brand:

*CVV2

Card security code

CVV2 for MasterCard, Visa and Discover cards. Enter 3 digits number shown on the signature side of these cards.
CVV2 for American Express. Enter The 4 digit number shown above the 15 digit number on the front side of the card.

*E-Mail Receipt:

Note: Registration confirmation and credit card receipt will be sent to the e-mail address listed above.