REGISTRATION FORM Sample s1

Registration Form MOV Users Group AOV Users Group January 9-11 MUG AUG Conference Week January 11-13 January 9-13, 2017 FLM Users Group CANUG January 10-12 January 9-13 JW Marriott Desert Springs Resort Expo January 9-12 74-855 Country Club Drive Expo January 9-12 Palm Desert, California 92260 MUG Limitorque Maintenance AUG Tours January 10 & Repair Training Enertech January 12 & half day 13 IMI CCI

Register using this form or ONLINE at: http://www.cvent.com/d/vvq8yw Interested in Exhibiting? Email [email protected] for space cost & availability.

Name of Attendee: ______Job Title: ______Company/Plant (if applicable):______Mailing Address: ______City: ______State/Province: ______Zip/Postal Code: ______Country: ______Phone & ext: ______Email: ______

CONFERENCE REGISTRATION (all fees listed in US Dollars):

Early bird rate/Standard rate. Early bird ends December 1st. Circle all that apply. MUG+AUG+FLMUG $600/$800 MUG $300/$400 MUG+FLMUG $600/$800 CANUG $300/$400 MUG+AUG $600/$800 AUG $300/$400 AUG+FLMUG $600/$800 CANUG+AUG $300/$400 Exhibit Staff $200 FLMUG $300/$400 MUG Limitorque Training (Thurs, 1/2day Fri), 30 ppl max $200 AUG All day Tour of Curtiss Wright/Enertech Tuesday: YES NO AUG All day Tour of IMI CCI Tuesday YES NO

TOTAL DUE $ ______PAYMENT METHOD Check or Money Order must be in U.S. funds payable to: Utilities Service Alliance. Ask for bank details for electronic transfer. Please check appropriate box:  Check  E-transfer  VISA  MasterCard  American Express  Discover

Expiration Date: ______Payment Amount $ ______Card #: ______Cardholder Name: ______Billing address if different from above: ______Please mail, fax, or email completed registration form with payment to: MUG AUG Conference Phone: (864) 882-7406 c/o Karen Miller FAX: (866) 882-8890 306 Coves End Pt Email: [email protected] Seneca, SC 29678

HOTEL RESERVATIONS - DEADLINE FOR RESERVATIONS IS WEDNESDAY DECEMBER 7, 2016 The conference rate at the JW Marriott is $196/night plus a $3/night resort fee plus tax, single/double occupancy. ---Reserve by phone: 1-877-622-3140. ---Reserve online: https://resweb.passkey.com/go/AOVMOV2017  A per diem rate is also available in our block, reserve by phone or email [email protected] for that link.  Our group rate will be honored for 3 days before and/or after the meeting dates if rooms are available. If you want extra nights, you must make your reservation by the phone number above, not the online link.  Cancellation with no penalty is allowed up to three days before arrival date.

QUESTIONS – Contact Karen Miller at [email protected] or 864-882-7406.