Gala
PA

To purchase tickets, please fill out the form below and click 'submit gala registration' or print out the registration form and send with payment to:

Technology Council of Central Pennsylvania
415 Market Street, Suite 201
Harrisburg, PA 17101

Please complete and return with payment by March 25, 2008

General Information
Company Name:
Address:
Address:
City:
State:
Zipcode:
Main contact name:
Main contact phone:
Main contact fax:
Main contact email:
Is your company a current Member of TCCP? Yes No

Quantity
Description
Price Each
Extended
Individual Attendance - member$150
4 attendees - member
(4 tickets)		$500
Corporate Sponsor - member
(10 tickets)		$2,000
Individual attendance - non-member$200
Amount Due:

Attendees to be registered:
Name (to be used on nametag)Company NameEmail


Method of Payment
Total ticket amount:
$
Pay via PayPal
Please call me to complete ticket purchase
Check should be mailed and be made payable to:

Technology Council of Central Pennsylvania
415 Market Street, Suite 201
Harrisburg, PA 17101


Please Note : If paying with PayPal, you will be directed away from this site to complete the transaction.
Technology Awards