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REGISTER HERE...
Name/Designation: ____________________________________________Company:_____________________________________________________
Address:______________________________________________________City, State, Zip: _______________________________________________
Phone: _______________________________________________________Fax:_ _________________________________________________________
Email:_________________________________________________________
Notes: Ultimate Partners receive 4 tickets, Elite Partners receive 2 tickets and Premier Partners receive 1 ticket.
____ # of partnership tickets
OR
____ $130.00 person
OR
____ $1,200.00 per table (10 guests per table)
Please list the name, company and designations of additional registrations.
2. _ ___________________________________________________________3. ____________________________________________________________
4. _ ___________________________________________________________5. ____________________________________________________________
6. _ ___________________________________________________________7. ____________________________________________________________
8. _ ___________________________________________________________9. ____________________________________________________________
10.____________________________________________________________
TOTAL DUE $_
___________________
Payment options:
Make check payable to CAI-NJ Mail completed form and payment to: CAI-NJ, 500 Harding Road, Freehold, NJ 07728
Pay by credit card below:
fax to (609) 588-0040 or email to
jaclyn@cainj.org.
Cardholder Name: _ _____________________________________________Card Number: ________________________________________________
Exp. Date: __________________ Security Code:______________________Cardholder Signature: _________________________________________
Cardholder acknowledges receipt of goods and/or services in the amount of the total shown here and agrees to perform the obligations set forth in the
cardholder’s agreement with issuer.
*Cancellation Policy-Cancellations must be made by February 8, 2018 in order to receive a refund. Swaps can be made at any time.