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2015 International Parachute Industry Association
Symposium
The Hilton Daytona Beach Oceanfront Resort, Daytona Florida, USA (Mar 30 — Apr 03, 2015)
Individual Registration Form
Please send completed registration form by fax or by mail to the 2015 Symposium Headquarters (See Footer)
Important Note: Save time by registering online: http://www.pia.com
Personal Information
(Name to appear on Identification Badge)
Name:
Company
Name:
Address:
Telephone:
City:
Fax:
Zip
Code:
State:
Country:
Email:
Registration Periods
Registration Pricing & Information
Full Registration
Full Registration
Single Day Pass
PIA Members
Affiliate & Non Members
Daily Exhibit Area Pass
Before Jan 31 2015
$195
$225
$110
$7 (Per Day)
Feb 1 2015 – April 3 2015
$295
$325
$110
$7 (Per Day)
Registration Type
Full Registration
•
•
Welcome Pack
Opening Ceremonies
•
•
Package Details
Exhibit Area Access
Seminars
Single Day Pass
•
Seminars
•
Exhibit Area Access
Daily Exhibit Area Pass
•
Access to Exhibit Area only
Participation in Riggers
Continued Education
Attending
Closing Banquet
T-Shirt Size
Registration Type:
Payment Method:
Closing Event
Yes
No
For more information related to the Continued Riggers Education
please refer to the PIA website
Yes
No
There will be no refunds for registrants not
attending the Closing Banquet
S
M
L
XL
T-shirt is standard with Full Registration only. Otherwise T-Shirts
can be purchased at a cost of $20
Payment Information
PIA Member Affiliate or Non Member Single Day Pass Daily Exhibit Area Pass
Card Type:
Credit Card Check
Visa
MasterCard
AMEX
Credit Card Number:
Card Expiration Date:
•
Name on Card:
Month:
Year:
Signature:
(Visa/MC — back of card — AMEX — Front of card)
Verification Code:
Billing address if
different from above:
Company Credit Card/Check
Personal Credit Card/Check
2015 PIA Symposium Headquarters, 404 W. Edinborough Ave, Raeford, NC 28376, U.S.A
Tel: ++ 910 875 9002 or 847 674 9742 — Fax: ++ 910 875 9272— E-Mail: [email protected] — Online:
www.piasymposium.com