APICS-OC PDM Reservation Form

Orange County APICS PDM Registration - Pay On-Line

Meeting Date *

February 19, 2020

Full Name *

First Name Last Name

Company

Title

E-mail *

Phone Number *

Area Code Phone Number

Dinner preference *

Standard Vegetarian Gluten Free None

Additional names (1 name/line)

Select Status (Quantity can be adjusted during checkout) *

Members - Early registration (1 point earned for certification maintenance) $ 25.00

Non-Members - Early registration $ 30.00

Students - Early registration (Proof of full-time onsite campus college student required) $ 15.00

OC Board Members - Early registration (1 point earned for certification maintenance) $ 15.00

Members - At the door (1 point earned for certification maintenance) $ 30.00

Non-Members - At the door $ 35.00

Students - At the door (Proof of full-time onsite campus college student required) $ 20.00

OC Board Members - At the door (1 point earned for certification maintenance) $ 15.00

Reservation will not be placed until payment is completed.