BPA University Online Registration Form

Streamlining Your Circulation and Auditing Process

March 19, 2007
Westin Michigan Avenue Chicago

All bpaww.com financial transactions are safe and secure.

Complete one form per attendee.

Team Registration Discount: Register and pay for three individuals from the same organization at the same time, and get a fourth registration free. (Early Bird vs. Standard Pricing cut-off dates/rates apply)

To register your 4th person, email Mike Rank at mrank@bpaww.com with the person's name, title, company,
email and phone number.

Credit Card #:
Exp. Date:

Name of Card Holder (as it appears on Card)

Check:
Company check to follow*** Check #:

Mail:
To register by Mail, print this form and send to:
BPA Worldwide
BPA University/March, C/O Julie Jawor,
2 Corporate Drive Ste. 900
Shelton, CT 06484-6259

Fax:
To register by Fax: Print this form and fax to 312.236-9075 Attn: BPA University

*** Signatures are required (if printing for fax or mail)

Cancellation Policy: Cancellations received in writing prior to February 9, 2007 will be refunded 80% of the registration fee. After February 9, there are no refunds, but BPA will gladly take substitutions/alternate attendees.

Cancellation/Substitution Requests Should Be Sent To:
BPA Worldwide
BPA University/March, C/O Julie Jawor,
2 Corporate Drive Ste. 900
Shelton, CT 06484-6259

Confirmation Notice: All submitted online registrations will receive a confirmation notice via email from BPA Worldwide within 48 business hours. Should you fail to receive a confirmation notice, please contact Mike Rank at (312) 236-9070.

NOTE: You may wish to print this screen for your records before submitting. You will be billed at the above address.