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Online Registration for Young Electrical Professionals

Summer Event: Island Party Hut on Chicago's Riverwalk

View the Event Information here

August 17, 2017 - 6:00p.m.

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

 

Registration Rate: $60 per person

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.

Refunds will not be given for this event with less than a 48 hour cancellation.

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