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Please tell us who you are (NAME) |
First*
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Last * |
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And how do
we get in touch with you? |
Address*
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2nd Line |
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City/State* |
Zip*
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(*required information) |
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Telephone* |
Email* |
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Event you are registering
for*:
If you selected a CPIM
Course above, please tell us which one.
Please list all attendees starting with
yourself if applicable, list the APICS ID Number to get the member rates:
If your organization has
a corporate membership check here and do not bother to fill in the APICS
ID No. |
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Name, Attendee 1 APICS
ID No. |
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Name, Attendee 2 APICS
ID No. |
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Name, Attendee 3 APICS
ID No. |
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Name, Attendee 4 APICS
ID No. |
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Name, Attendee 5 APICS
ID No. |
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Name, Attendee 6 APICS
ID No. |
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Name, Attendee 7 APICS
ID No. |
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How will
you be making Payment for this event? We accept Credit Cards through Pay
Pal |
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PREPAY
Please remit to address below. |
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Credit Card Via PayPal
Company Name |
Address
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 Address
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State
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Zip
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Make Checks Payable to;
Central New Hampshire Chapter
of APICS, Inc
PO Box 1631
Laconia, NH 03247-1631 |
