Symposium Registration Attendee - AIA Middle Pennsylvania Chapter

Below is the registration form for the Symposium. We use PAYPAL to process the transactions and you will be re-directed to a payment page after clicking “SUBMIT AND PAY”. Your order will not be processed unless you complete payment. You do not need a paypal account.

Questions can be directed to Pamela Crooks at pennsylvaniacrooks@yahoo.com or 814.241.8379

Contact Person*
First Last
Company Name
Address*
Street Address City State ZIP Code
Phone*
Email*
AIA Membership*
Tickets Needed*
- DAY Tickets
- EVENING Tickets
Pricing: AIA MEMBERS
$200 Early Bird prior to October 1st
$225 October 1- October 26
$45 Evening Reception and Dinner

NON- AIA MEMBERS
$225 Early Bird prior to October 1st
$250 October 1- October 26
$45 Evening Reception and Dinner
Day Tickets
Day Symposium Tickets (Early Bird MEMBER)*
Early Bird prior to October 1
Day Symposium Tickets (MEMBER)*
Day Symposium Tickets (Early Bird NON-MEMBER)*
Early Bird prior to October 1
Day Symposium Tickets (NON-MEMBER)*
Day Attendee Names*
Please type all DAY attendee names here.
Evening Tickets
Evening Reception Tickets*
Evening Attendee Names*
Please type all EVENING attendee names here.
Ticket Cost
Total
$0.00
PLEASE NOTE: YOU DO NOT NEED A PAYPAL ACCOUNT TO PURCHASE TICKETS.
ON THE PAYMENT PAGE SELECT "PAY WITH DEBIT OR CREDIT CARD".
Email
This field is for validation purposes and should be left unchanged.

Day Tickets

Evening Tickets

Ticket Cost