OFFICE USE ONLY
Reg#________________
Date________________


Registration Form

2010 Yankee Security Conference & Trade Show
October 20-24
Sturbridge Host Hotel, Sturdbridge, MA
Yankee Logo

Please Complete and Submit. For questions call 1.800.209.8266 or fax 781.395.0634

NAME______________________________________________  PHONE_________________________  EXTENSION____________

TRADE ASSOCIATION NAME__________________________________________________________________________________

HOME ADDRESS____________________________________________________________________________________________

CITY/TOWN_________________________________________________  STATE______________   ZIP_______________________

BUSINESS NAME____________________________________________   PHONE______________________   EXTENSION________

BUSINESS ADDRESS_________________________________________________________________________________________

CITY/TOWN_________________________________________________  STATE______________   ZIP_______________________

EMAIL ADDRESS Email me a receipt

SPOUSE/COMPANION OR CHILDREN ATTENDING
(LIST ALL NAMES):

___________________________________________________________________________________________
Deadline for registration is Oct. 15, 2010. Registration before this deadline is free.
You must be registered to attend classes and the trade show. Forms received after
Oct. 15, 2010 require a $10 per person registration fee.
TOTAL PERSONS TO BE REGISTERED # POST-DEADLINE LATE FEE (IF ANY)

CLASS REGISTRATION ENROLLMENT GRID
Please fill out this form for each class attendee.
CLASS DATE
CLASS DAY
CLASS #
(1st Choice)
CLASS #
(2nd Choice)
CLASS COST
Wednesday
10/21/09
DAY
Class #
Class #
NIGHT
Class #
Class #
FREE
Thurdsay
10/22/09
DAY
Class #
Class #
NIGHT
Class #
Class #
FREE
Friday
10/23/09
DAY
Class #
Class #
NIGHT
Class #
Class #
FREE


 

 

 

                
                                                                              
                                                                                
                                                                                

                                                                         
                                                                                 

                                                                                    TOTAL amount due $ (no cents)

IMPORTANT: If you are sending a check, make sure your company name is on it, and mail to:
Yankee Security Convention, P.O.Box 70, Medford, MA. 02155

Or "please charge my credit card".

Master Card #___________________________________ Visa Card#___________________________________

Expiration Date ______/_______(month/year) Payment must accompany registration.
I hereby certify that the above listed applicant: 1) works or is employed in the security industry; 2) has not been convicted
of a felony; and 3) will not use the information or training received for any improper purpose. I will indemnity and hold harmless
Yankee Security Convention, Inc. and it's directors or officers. I also will allow the usage of my photo for Yankee Security
promotional purposes.

Signature _____________________________________   Date ______/________/______(month/day/year)

We will process your registration, and, if received early enough, your package will be ready at the registration desk on arrival.
                                                          Please Mail Your Completed Form