Partners In Contracting Corp. - Attendee's Registration Form 2012

2012 Government Contracting Procurement Expo

Attendee Registration Form

Registration Fee $150.00
Included with your fee is Tuesday evening reception, Wednesday Breakfast Buffet and sit down lunch, vender booths and workshops.
Attendee*:
Name of Business*:
Address*:
City*:
State*:
Zip Code*:
Phone*:
Email Address*:
Please tell us about your business.
Brief description of company's primary product or service:
Is your company a small business as defined by the SBA?:	YES NO
Are you a PICC client?:	YESNO
Is your company owned by:	MinorityWomanVeteranDisabled Veteran
Is your company registered on the Central Contract Register (CCR) as a:	MinorityWomanVeteranDisabled Veteran
Is your company state of Indiana certified as:	MinorityWomen
Does your company have any of the following designations?:	Certified HUBZone8ASDBINDOT Disadvantage Business Enterprise
Payment method
Please choose an option.*:
When you SUBMIT FORM you will be directed to another page with additional payment information.
If you are mailing in a check, please print this page before you submit and attach to check.

You need to submit a form for each person attending.