Pasadena & Foothill Chapter AIA   2004 DESIGN AWARDS
 
RSVP / Registration to Attend Design Awards Event
Saturday, September 25, 2004
5:30 PM to 10:00 PM
Junior Achievement of Southern California
6250 Forest Lawn Drive
Los Angeles, CA 90068
This form must be submitted and the payment received
by September 15, 2004
Registration closed!
As an option, you may call in your request for a registration to:
(626) 796-7601
All fields with yellow background and asterix (*) are required.
Please provide the following required information in the form below:
  • Choose payment method: PayPal (Credit Card) or Check
  • First name of contact person
  • Last name of contact person
  • Email Address
  • Phone Number
  • The names of the person(s) for whom you are registering.

You will receive an automated reply with all the information that you provide in this form for your records to the E-mail address specified below.
Reservation to attend the Awards Event:
Number of Persons (max. 10 per registration) @ $60.00
OR
Table for 10 @ $500.00
Students (ID required)
Number of Students @ $20.00
All payments are non-refundable Total
Payments can be made, after submitting this form, by
PayPal (Credit Card)
or
Check made out to "P&F AIA" and sent to
555 S. Oak Knoll Ave., Pasadena, CA 911101

Payment must be received by September 15th for a valid registration.
Payment Is:    by PayPal (Credit Card)     by Check
Contact Person:
First Name *
Last Name *
Firm/Company (optional)
Email *
Phone *
Please enter the names of all persons (including
contact person if attending) included in this reservation:
1:    *
2:   
3:   
4:   
5:   
6:   
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10:   
empty
Registration closed!

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