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NOTE: This form is for credit card registration.
For check or cash payment click your browsers back button and print the mail in form.
If you need assistance with online registration call Tom Tudor at 909-647-5515.
The Southern California Society of Plastics Engineers is dedicated to support the plastics industries. We are industry professionals with a strong believe in growth through shared knowledge and the value of sharing what we have learned with each other. Additionally we are committed to raising awareness to college and high school students of the many career choices they have in plastics. SPE is a non profit organization. Your monetary contribution helps fund our sections dinner meetings, seminars, workshops and scholarship programs. For help with this form contact Tom Tudor 909-647-5515.
Registration
Registration 6:00PM, Dinner 6:30PM, program and awards to follow.
Participant 1 First Name
Last Name
Choose options
Choose Item
Attendee $30.00
Teacher or Parent $15.00
Student $2.00
Participant 2 First Name
Last Name
Choose options
Choose Item
Attendee $30.00
Teacher or Parent $15.00
Student $2.00
Participant 3 First Name
Last Name
Choose options
Choose Item
Attendee $30.00
Teacher or Parent $15.00
Student $2.00
Participant 4 First Name
Last Name
Choose options
Choose Item
Attendee $30.00
Teacher or Parent $15.00
Student $2.00
Name
Sponsor Company
Fill in the event you would like to sponsor
Donations (optional)
Event Sponsor (optional)
Help sponsor this event with as a Tee sponsor or Pin Flag sponsor.
Tees will have your comany information posted as a sponsor.
Pin flag will have a custom flag made with your company information. You keep the flag too!
Tee Sponsor
I will sponsor a Tee
Choose options
Choose sponsor $
Sopnsor a sponsor $25.00
Sponsor two students $50.00
Sponsor four students $100.00
Corporate Sponsor or table top $150.00
Pin Flag sponsor
I will sponsor a Pin Flag
Sponsor/Donation amount $
Total Billing To Credit Card
Total:
Billing Information
Company:
*Address Line-1:
Address Line-2:
*City:
*State:
Select State
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
*Zip Code:
*Phone:
888-888-8888
Credit/Debit Card Information
*First Name:
Middle Initial:
*Last Name:
*Card Number:
*Expiration Month:
Month
January
February
March
April
May
June
July
August
September
October
November
December
*Expiration Year:
Year
2020
2021
2022
2023
2024
2025
2026
2015
*Card Brand:
Choose a Card
American Express
Discover
Master Card
Visa
*Security CVV:
Note: Registration confirmation and credit card receipt will be sent to the e-mail address listed above.
Substitutions: You can substitute registered attendees at any time.
Refunds: No refunds for cancellations made less than seven days prior to the event.
Privacy(member and non-member): The Society of Plastics Engineers, Southern California does not
retain credit card information. Address and email may be used to provide you with information on
future Southern California SPE events.
CVV2 for MasterCard, Visa and Discover cards. Enter 3 digits number shown on the signature side of these cards.
CVV2 for American Express. Enter The 4 digit number shown above the 15 digit number on the front side of the card.
*E-Mail Receipt:
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