2012 Mid-Winter Conference
Delegate Registration Form

AMVETS

Delegates fees = $20.00 pre-registration (no later then February 8th)$25.00 registration at Conference

The AMVETS Department of Ohio is continuing our online registration.

You can register as an individual or a Post can register all of their delegates at once.

If you or your Post does not wish to register through internet access, you may print this form and return it with payment to Department Headquarters.

Line

List below ONLY those individuals who are

attending the Conference as delegates.

 

Post# A value is required.Invalid format.

Post Commander
First Name:
Last Name:
Badge*:
Member ID:
Post Adjutant:
 
First Name:
Last Name:
Badge*:
Member ID:
State Elected Officers
(SEC Only)
 
First Name:
Last Name:
Badge*:
Member ID:
Past Dept. Commander
 
First Name:
Last Name:
Badge*:
Member ID:
Post Delegates
First Name:
Last Name:
Badge:
Member ID:
Post Alternates
 

* - This is the name you would like displayed on your Name badge.

PAYMENTS

# of Delegates X $20.00 (pre-reg) = $

Visa MasterCard Discover

Credit Card Number: Invalid format.A value is required. Expiration Date (Use 4 digit number) A value is required.Minimum number of characters not met.Exceeded maximum number of characters.

Name as it appears on the Credit Card: A value is required.

Billing Address for Credit Card

Street Address: A value is required.

City: A value is required. State: A value is required.Minimum number of characters not met.Exceeded maximum number of characters. Zip: A value is required.Invalid format.

Email Address A value is required.Invalid format.

 

All Registrations are Non-Refundable

Note: Registration is being sent by secure email. Your credit card will not be charged immediately, Department Headquarters will run the charge from their secure site.

 

If YOU WOULD LIKE THIS FOR YOUR RECORDS PRINT THIS PAGE BEFORE YOU HIT THE SUBMIT BUTTON!!!!

 

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After hitting the Submit button you should be taken to a Thank You page, if not please check to see if there are any errors on the page.