2007 Sacramento Valley Chapter PTG Event Registration Form
Each Registration Includes One Catered Lunch

Member Status: ____ RPT ____ Associate ____ Sustaining ____ Honorary ____ Other

PTG Chapter ____________________________________________ __________________________

Email Address: _____________________________________________________________________

Phone 1 __________________________________ Phone 2 _________________________________

Company / School ___________________________________________________________________

First Name ____________________________________ ____________________________________

Last Name _________________________________________________________________________

Address ___________________________________________________________________________
(If using credit card, address information must match billing statement of Credit Card)

City ____________________________ State _______ Zip ___________ Country ________________

Additional Names (PTGA - Other): First Name ____________________________________________

                                                       Last Name ____________________________________________

Credit Card Info: (If using credit card, address information above must match billing statement of Credit Card)

Name on Card __________________________________________________________

Type of card _____ American Express _____ MasterCard ____ Visa ____ Discover

Card Number ______________________________ Expiration ________________________

Please Note: Credit Card transactions will be processed by Sierra Software Services, owned by Sac Chapter
member Tremaine Parsons RPT. No Charge Backs Please! Banks now charge a $50.00 administration fee.

Registration Options:

____ PTG Member Technician Registration (By Sept 1) $100.00 _____________

____ Non-Member Technician Registration (by Sept 1) $125.00 _____________

Please Select Desired Sandwich below (side salad included )               Enter Total Here _____________

__Ham and Swiss with Honey Mustard    __Roast Turkey with Cranberry    __Turkey Club  
__Rosemary Chicken    __Three Cheese Vegetarian    __Sun Dried Tomato Vegetarian

Make Checks Payable to: Sacramento Valley Chapter PTG
If registering by mail, address to: Mabel Chan 3280 Black Oak Drive, Rocklin, Ca 95765 Phone: 916-205-7722
General Registration Questions: Gene Nelson 530-677-3366 nelsong@pbic.net
Register online at www.sacptg.org Online registration contact: Tremaine Parsons admin@sacptg.org

Registration prices after September 20 2007 will not change but a catered lunch will not be provided.
Early registration is advisable because of limited classroom space.
Parking fee is $5.00 – not included in registration fee. Parking ticket must be purchased at ticket machines.
Visit our web site at www.sacptg.org for directions to the University, Capistrano Hall, parking and parking ticket machines.
Location: Sacramento State University 6000 J St Sacramento Ca 95819 Phone: 916-278-4933
Date: September 29 2007