Registration Form
2012 Yankee Security Conference & Trade Show
October 17-21
Sturbridge Host Hotel, Sturdbridge, MA
Yankee Logo

Click Here for Printable Version

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

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

Deadline for registration is Oct. 10, 2012. Registration before this deadline is free.
You must be registered to attend classes and the trade show. Forms received after
Oct. 10, 2012 require a $10 per person registration fee.

TOTAL PERSONS TO BE REGISTERED  POST-DEADLINE LATE FEE (IF ANY)

CLASS DATE
CLASS DAY
CLASS #
(1st Choice)
CLASS #
(2nd Choice)
CLASS COST
 
Wednesday
10/17/12
DAY
NIGHT
FREE
Thursday
10/18/11
DAY
$ (no cents)
NIGHT
FREE
Friday
10/19/11
DAY
$ (no cents)
NIGHT
FREE

CLASS REGISTRATION ENROLLMENT GRID
Please fill out this form for each class attendee.


 

 

 

 

 

 

 

 

                                                                                         


                                                                                          

                                                                                         

 

 

 

                                                                                           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

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 (type in your name)    Date (month/day/year)
Repeat     (type in your name)

We will process your registration, and, if received early enough, your package will be ready at the registration desk when you arrive.

SUBMIT YOUR COMPLETED FORM    (Click once) 
You will receive acknowledement in the mail.

                                                                                   

OFFICE USE ONLY
Reg. #_______________

Date_________________