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Identification/Contact Information |
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*Gender :
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*First Name:
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*Last Name:
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*Title:
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*Store Name/Company: |
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| *Street
Address1:
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*City:
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*Country:
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*State/Province:
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*Zip/Postal Code:
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*Phone Number:
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*Fax Number:
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*Email Address:
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Membership |
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*Membership
Type: |
IGA Member
Non-IGA Member |
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Registration Fees (early bird effective
before September 24th) |
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*Registration
Fees: |
IGA
- $2,100
Non-IGA -
$2,700
Early Bird
IGA - $1,800
Early Bird
Non-IGA - $2,300 |
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Payment Information |
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*Payment
Type: |
Credit
Card
Wire
Transfer
Bill
Me |
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If
you are paying with a credit card you will be contacted via
telephone for the necessary information. |
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Billing Info - Send To: |
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Hotel
Information
The Hampton Inn, 244 North Ave, Atlanta, GA 30313
The IGA Coca-Cola Institute has
reserved a block of rooms @ The Hampton. By completing this
registration form, a room reservation will be made for you.
Upon arrival, present your credit card. Please indicate your room
preference below and include your arrival and departure dates.
Room rate (per night) before October 1st - $115
October 1st and after - based on availability |
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Remarks |
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Remarks:
(Max.
80 characters) |
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Special Needs:
(Max.
300 characters) |
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