Name & Contact Data
First Name
Last Name
Company Name
Work Phone
Email Addresses (use a comma to seperate multiple email addresses)
Registration Type:
Charge the presenter fee to your card?
Name Tag
Title
Reservation Information
The conference begins May 18 and ends May 25.
Select Arrival Date
Select Departure Date
Room Type
select
select
select
Credit Card  
Credit Card Number
Credit Card Expiration (Mnth/Yr)
select
select
select
Special Requests
Spouse/Companion
There is a $200 fee for guests that will be attending the conference with you.

Guest Name
Children attending the conference with you
Will you be bringing children to the conference?
Please list the children and their ages who will be attending the conference with you.
Child Name
Child Age


Once you click Submit you are subject to a $100.00 Penalty for Cancellation
EPG 2012 Conference Admin Login