2012 Atlas Reservation Form

February 6 - 2012 Atlas Award

Please be sure to enter the total number of attendees for each program you select (including yourself), as well as names, for each event you plan to attend.

#  Individual Subscriber $225 (includes one ticket to cocktail and hors d’oeuvre reception, program and dinner). To reserve tables or for additional sponsorship levels, please contact 215-561-4700, ext. 232 or ext. 222.

Attendee Name(s)

 

I cannot attend but wish to make a contribution to support the attendance of troops and their families
Donation amount: $

All attendees and contributors are invited to submit the name of a service member or veteran to be included in the program book dedication list:

 

Not a member? Learn about membership benefits or join now.

 

First Name *

Last Name *   Title  

Company Title  

Company Name  

Address 1 *  

Address 2 *  

City *  

State *   Zip Code *  

Phone *  

Phone type
 

 

Credit Card Type  Visa   MasterCard   AmEx

Card Number 

Expiration Date  (mm/yy)

SIC/"V" Code    Click here to view SIC/V location

Credit Card Billing Address (if different than above)  

E-mail *  

The Council sends regular e-mail newsletters on upcoming programs, travel opportunities, membership benefits and reminders. Your e-mail address is important to ensure that you are kept up to date on Council events and short-notice advisories on programs. You will be automatically added to our e-mail subscriber list for this reason. However, if you do NOT wish to receive any e-mail from the Council, you may unsubscribe at any time by sending an e-mail to membership@wacphila.org.

 I am a Young Professional between the ages of 21 and 35. Please send me information about Young Professionals events.

How did you hear about this program(s)?

Council newsletter
Council e-mail broadcast
Special e-mail offer
Council website
Through a friend
Facebook
Twitter
Newspaper or radio ad (please note publication/station and date)

Through an organization (which one?)

Other

Please be sure you have read Reservation Policies section at right before submitting

Registration Information

Once we have received your reservation, we will send you an e-mail confirmation. However, you may wish to print this form once completed (and before you click "submit") and bring it with you to the event(s). Alternatively, you may print this page and fax it to 215-561-5660 or mail it to the Council with your payment. If you have not received a confirmation within 3 days of submission, please contact the Council at 215-561-4700, ext. 235 or 227.

Please note that this online reservation form MAY NOT be used with lecture passes. Reservations using lecture passes must be mailed in and the pass(es) must accompany the reservation or be received by the Council at least three business days prior to the event in order to guarantee your reservation. See Reservation Policies below for more information.

High school students must make reservations through the Council's Education staff. Please call 215-561-4700 for details.

Fields followed by * are required and must be completed before submitting the form.

Enter the number of attendees for each program/program option below, including yourself. When entering guest Attendee Name(s), including yourself, please use a comma to separate each name (and title, if applicable). Please note that guest prices are dependent on membership level:

Individual — all guests charged at general public price

Dual level and higher — one guest at member price, additional guests at general public price

If you are unsure of your membership level, please call 215-561-4700, ext. 200 or 222. The Council generally issues name tags for its programs. If you and your guests would like to be identified by your title and company, please provide this information for yourself and for each of your guests as Name and (if applicable) Title and Company.

Reservation Policies

Payment: The Council will only guarantee reservations paid in advance, including receipt of lecture passes with reservations. Reservations are accepted in order of receipt. VISA, MasterCard and American Express are accepted. If using the printed form and mailing your reservation, payment or lecture pass must accompany the form and must be received by the Council three business days prior to the event to guarantee your reservation.

Confirmation: Notices or tickets are generally not sent. Your name tag at the event will serve as an admission "ticket."

Cancellations: Cancellations must be made at least three business days prior to the program in order to receive a refund. Day trips require five business days notice for refund.