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Register Now!

agc09


INSTRUCTIONS (Complete all sections)
  • To register: Complete form and click on submit button. Payment must be made with a credit card to submit online registration.
  • Badges will be available for pick up onsite.
  • To fax/mail the Registration Form, click here.
  • Questions? Call toll-free 866/DIAL NGA (342-5642), ext. 134.
1. REGISTRATION OPTIONS

Registration includes entry to all conference functions.
NGA Member
Advance Registration—by 2/6/09
NGA Member Registration................ [FC] $350 ea.  
 
On-Site Registration—bring on-site after 2/6/09
NGA Member Registration ................ $400 ea.

Non-Member
  Registration (Advance or On-Site) ................... [NM] $950 ea.
2. PAYMENT METHOD
AMEX  VISA  MC 
Card#: 
Exp.Date:
Name on Card: 

3. PERSONAL INFORMATION
Last:
First:
Title: 
Company:
Address:
City:
State:
Zip:
Country: 
Phone: 
Fax:
E-mail address:
Indicate special needs: 
Are you an NGA Certified Auto Glass Technician or Auto Glass Repair Technician? Yes  No 

4. PLEASE COMPLETE THE FOLLOWING:
Primary business (Check one)

1. Dealer/retailer
2. Distributor
3. Manufacturer 
4. Automotive body repair shop 
5. Car dealership 
6. Insurance company 
7. Other 


 
Job function (Check one)
(M) Management/Ownership
(P) Purchasing
(S) Sales
(I) Installation
(O) Other  		Purchasing authority (Check one)
(A) Purchase
(B) Recommend
(C) Specify

 

Annual Sales Volume (Check one)
 
(A) Under $250,000 
(B) $250,000-$500,000 
(C) $500,000-$1 Million
(D) $1 Million - $5 Million 
(E) Over $5 Million 
 
 

FREE Subscription to the new Glass magazine:

(Note: All information must be supplied above to receive your free subscription.)
Free subscriptions available to non-subscribers and registered attendees to the Auto Glass Conference only.
Yes, I wish to receive a FREE subscription to the new Glass magazine.

In lieu of a signature, what state were you born in?

Cancellations:
All cancellations must be received in writing on or before February 1, 2009. A processing fee will be charged against each cancellation. All refunds will be processed after the conference. No refunds will be made for cancellations after
February 1, 2009 or for "no-shows."
 




Please click on the Submit Form button once. It may take a couple of moments to process. You should be directed to a confirmation page and receive a confirmation email. If you do not receive an email, please contact Sam Carothers at 866/342-5642, ext. 134 or email scarothers@glass.org.

Please allow three weeks for processing and confirmation.



 
 
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