TechNite19 Reservations - Shenandoah Valley Technology Council

I am making a reservation for

Name*

First Last

Title

(In the title line, use your job title, academic rank, or position info - this will be included on your nametag. Leave blank if you'd like.)

Organization

Address

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

If you would like the INVOICE for any of these reservations sent to a DIFFERENT email address than the one above, please enter that email address here and we will use it to communicate about billing/invoicing.

Check the corresponding box if any of these special circumstances apply. If not, please leave blank.

I am an award nominee
I am a SVTC Board Member
I require a vegetarian meal

NOTE: if you are the GUEST OF A SPONSOR please do not make a reservation using this form. Sponsors communicate the details of their guests via email. - All guests: We will pre‐print nametags; and confirm your attendance via email 1-2 days prior to event (incl. parking info).

Register another attendee (optional)

Skip this section if you do not plan to register another attendee.

Name

First Last

Title

(In the title line, use your job title, academic rank, or position info - this will be included on your nametag. Leave blank if you'd like.)

Organization

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Check the corresponding box if any of these special circumstances apply. If not, please leave blank.

Second attendee is an award nominee
Second attendee is also a SVTC Board Member
Second attendee requires a vegetarian meal

NOTE: if you are the GUEST OF A SPONSOR please do not make a reservation using this form. Sponsors will communicate the details of their guests. -- FYI: We will pre‐print nametags for all guests and also will send an attendance confirmation via email, to all guests, a few days prior to the event.

Phone

Email

Pricing & Payment

PRICE: $75 per individual ticket.

MULTIPLE RESERVATIONS: If you want to make a reservation for more than 4 attendees at the same time, you can either visit the SVTC TN19 reservation page again or send Nicky an email at info@svtc‐va.org and she will accommodate you.

PAYMENT OPTIONS:
1. Checks: After making a reservation online, send a check to: SVTC, 800 S. Main Street, MSC 3615, Harrisonburg, VA 22807 (by April 25, 2019). Please include a note.
2. Credit cards: After receiving an online reservation, we send an invoice with a credit card payment link *by email*, -- simply follow the link in the email to make a payment.
3. Sponsors and those who are/were invited to sit at a sponsored (reserved) table should not use this form. (Sponsors communicate about their guests' details differently.)

CONFIRMATION: We will email attendance confirmations to all attendees that include all the details of the event, e.g. parking, driving directions, location, and attire info.

CANCELLATION NOTE: In order to receive a refund, any cancellations must be made by April 25, 2019. No refunds after that date.

Questions? Please call us at 540‐568‐7882 or email us at info@svtc‐va.org.

PHOTO RELEASE: By registering for this event, I hereby consent to and authorize the use and reproduction, in print or electronic format, by the Shenandoah Valley Technology Council or its authorized agents, of any and all photographs or video which may be taken of me at this event, for any publicity purpose, without compensation. I acknowledge and agree that all images, whether electronic, negatives and positives or otherwise, together with the prints, are owned by the SVTC. I hereby acknowledge that I am 18 years of age or older and have read and understood the terms of this authorization and release.

Email

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TechNite19 Reservation Form

I am making a reservation for

Register another attendee (optional)

Pricing & Payment

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