previous page  2007 CA-PTG Conference Registration Form  previous page
Each Registration Includes One Banquet Ticket ( __ Check here for Vegi)
Member Status: ____ RPT ____ Associate ____ Sustaining ____ Honorary ____ Other

PTG Chapter ____________________________________________ CAUT Technician ? _________

Email Address: ____________________________________________________________________

Phone 1 __________________________________ Phone 2 _________________________________

Company / School __________________________________________________________________

First Name ____________________________________ Nick Name ___________________________

Last Name ________________________________________________________________________

Address _________________________________________________________________________
(if using credit card, address information must match billing statement of Credit Card)

City ____________________________ State _______ Zip ___________ Country ________________

Additional Name (PTGA - Other):    First Name _____________________________________________
Nick Name ___________________ Last Name _____________________________________________

Credit Card Info: (if using credit card, address information above must match billing statement of Credit Card)

Name on Card __________________________________________________________
Card Number _______________________________________ Expiration ________________________

Registration Options: (One Technician Registration per submission. You may also add one PTGA or Family/Friend)
Registration Options:                                                                                        Enter Amount

____ PTG Member Technician Reg. (by Jan 23rd)                                    $275.00 _____________
____ Non-Member Technician Registration (by Jan 23rd)                              $325.00 _____________
____ PTG Member Technician Reg. (after Jan 23rd)                                 $325.00 _____________
____ Non-Member Technician Registration (after Jan 23rd)                           $375.00 _____________
____ PTGA or Family/Friend Registration                                              $135.00 _____________
____ Extra Banquet Ticket                                                                       $  50.00 _____________

SPECIAL INTENSIVE SEMINARS:

____ All Day Grand Regulating Class - Richard Davenport RPT            $  25.00 _____________
____ 4 Period Technical Repair Skills - Stevens/Stevens (Friday - All Day - Limit 15 - tools required)
____ Thursday One Day Grand Piano Upgrade class - B. Spurlock (No Limit)
____ Hands-On Grand Action Renovation - Pianotek (Saturday All Day)
____ Grand Action Renovation Weighting - Pianotek (Sunday AM)
                                                                                                     Enter Total Here _______________
Make Checks Payable to: California State Conference PTG
If registering by mail, address to: Tom Cole, CA-PTG Registrar, 908 Sumner St., Santa Cruz CA 95062 Ph: 831-459-9910
If registering by Fax: (831) 459-9910 or Register online at www.santaclaraptg.org - tcole@cruzio.com
Hotel: San Francisco Airport Marriott - Phone: 1-800-228-9290 (group code: ptgptga) PTG Group Rate: $96.00
per night + tax - Group Rate Cut-off date is on, or before Wed Jan 18th