GHSHRM August Educational Luncheon
Thursday, August 01, 2019
11:30 AM - 1:00 PM
Location: Tony's Restaurant
Directions: 3755 Richmond Avenue, Houston, TX 77046

REGISTRANT * required
First Name *

Last Name *

Title *

Company

CONTACT INFORMATION
Phone Work (include area code) *

Cell Phone (include area code)

E-mail *

Please re-type your email address *

 

MEMBER TYPE *
Member and Guest(s) - $30 per person
Non-Member and Guest(s) - $35 per person
Student and Guest(s) - $20 per person

# OF ATTENDEES INCLUDING GUESTS


GUEST NAME(S)
 


# OF VEGETARIAN MEALS


TOTAL AMOUNT
$

     
Method of Payment:
 Pay at the Door    Credit Card

Credit Card Information (all fields required)
Card Type

Cardholder's First Name

Cardholder's Last Name

Credit Card Number

Exp Date
(e.g.: 05/2020)
Security Code

 

Cardholder's Billing Street Address

Billing City

Billing State
(2-digit state code)
Billing Zip Code

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