2017 AWIG - Sign up

AWIG Conference Sign Up: 3 Easy Steps!

Please note: This year Hotel bookings are done direct. A link willl be provided to you after your sign up.

Step 1: Attendance Details

   
Number of Attendees   Children 6 -14
 

Step 2: Person(s) Attending

Primary Person: AWIG Information

Title
First Name
 Initial
Last Name
Specialty
Day Phone
Evening Phone
Street
Line 2
City
State/Province
Country
ZIP
Email
Registration Fee
AWIG Member fees $100/year For AWIG members only

Primary Dates:

Arrival Date*

Departure Date*

* All dates must be YYYY-MM-DD

Second Person: AWIG Information

Title
First Name Last Name
Specialty* Email*
Country* Attendee Status
* Fields are required for Certificate of Attendance (If Required for this Person)

Second Person Dates:

Arrival Date Departure Date

Third Person: AWIG Information

Title
First Name Last Name
Specialty* Email*
Country* Attendee Status
* Fields are required for Certificate of Attendance (If Required for this Person)

Third Person Dates:

Arrival Date Departure Date

Child #1 - Dates

Arrival Date

Departure Date

Child #2 - Dates

Arrival Date

Departure Date

Step 3: Summary & Payment

Person(s) AWIG Dues Reg Fee Sub-Total
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
       

TOTAL $USD

   
CARD TYPE
CARD NUMBER
EXPRIATION DATE mm/yy