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January-February 2017

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DATES Wednesday, March 8 through Friday, March 10, 2017 (Committee meetings: March 8) CANCELLATION POLICY Cancellations must be submitted in writing. If received by January 31, 2017, a refund will be issued, minus a $100 administrative fee for attendees. No refunds will be issued for cancellation requests received after January 31, however, substitutions are permitted. REGISTER ONLINE Online www.palletcentral.com/events Fax 1-703-519-4720 Mail NWPCA 1421 Prince Street, Suite 340 Alexandria, VA 22314-2805 E-mail Scan and E-mail to: msullivan@palletcentral.com NATIONAL WOODEN PALLET AND CONTAINER ASSOCIATION 2017 NWPCA Annual Leadership Conference & Exposition MARCH 8-10, 2017 | TUCSON, ARIZONA ATTENDEE REGISTRATION Name:____________________________________________________ First name for badge:____________________ Title:________________________________________ Company:____________________________________________ Address:__________________________________________________________________________________________ City:__________________________________ State:__________ Zip:____________ Country: ______________ Phone: ________________________________ Email:____________________________________________________ o Special accommodations required (attach a written description of any mobility or dietary needs you require). RATES Total NWPCA Member $945 = $________ Non-member $1,475 = $________ Spouse/Guest (non-industry) $425 = $________ Spouse/Guest: First Name: _________________________________ Last Name:__________________________________ Child (meals only pkg) $150 x # = $________ OPTIONAL EVENTS Golf Tournament (Wed. March 8) (per person) $225 x # = $________ Golf Handicap: ___________________________________ Do you wish to rent golf clubs? (reservation only – pay club directly onsite) o Men's Clubs o Right Handed ________ o Left Handed _________ o Women's Clubs o Right Handed ________ o Left Handed _________ Tennis Tournament (Wed. March 8) (per person) $50 x # = $________ PAYMENT o Check (payable to NWPCA) o Mastercard o Visa o American Express Credit card number: Exp. date: CSV: Name on card: __________________________________________________________________________________________________ Signature:________________________________________________________________________________________________________ 0000000000000000 00 00 / $ Total Amount Due 0000 Child 1: Child 2: First Name:________________________ First Name:____________________________ Last Name:________________________ Last Name: ____________________________ PLEASE PRINT One registration form per business contact.

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