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Online Registration for:

Communication Technologies Forum Summer Social June 21, 2017 - Lake Michigan Fireworks Cruise

View Event Details here

(An email will be sent to all registrants a few days before the event with parking, location, and boarding information.)

Full Name
Company
Company Street Address
Company City, State, ZIP
Phone
Fax
Email Address
   

Registration Fees

 

Attendee registration fee: $125 per person (Includes privately chartered cruise under Navy Pier's fireworks, open bar - beer/wine/soft drinks, and sandwich buffet)

Total Amount:
  You can print this form and mail it with a check to the Electric Association: 17W733 Butterfield Road, Suite B, Oakbrook Terrace, IL 60181 (or) Visa, MasterCard, and American Express are accepted below.
Method of Payment (a 5% convenience charge will be added to all credit card payments)
Credit Card Number
CC Exp. Date
Cardholder name
  Credit card billing address is the same as company address above

If credit card billing address is different from company address, please specify below:
CC Billing Street Address
CC Billing City, State, ZIP