<p> American Governor Company Analog Focus Class Registration Form 27 Richard Road, Ivyland PA 18974 Phone: 215-354-1144, Fax: 215-354-1782 http://www.americangovernor.com</p><p>Woodward Analog Focus Class October 24 - 25, 2017</p><p>Registration fee is $2,575.00* per person. VISA and MasterCard accepted. </p><p>Fax to 215-354-1782 or email to [email protected]</p><p>Attendee Information Attendee 1 Attendee 2 Attendee 3</p><p>Name:</p><p>Title:</p><p>Company:</p><p>Plant Name / Location:</p><p>Attendee Phone:</p><p>Attendee Fax:</p><p>Attendee Email:</p><p>Attendee Street Address:</p><p>City, ST, Zip Code</p><p>Country:</p><p>Registered By:</p><p>Referred By:</p><p>Registration Date:</p><p>Method of Payment Attendee 1 Attendee 2 Attendee 3</p><p>Check or PO Number:</p><p>Visa or Mastercard #</p><p>Exp. Date (10/17 or Later):</p><p>Name on Card:</p><p>Cardholder Phone:</p><p>Cardholder Fax:</p><p>Cardholder Email:</p><p>Cardholder Street Address:</p><p>City, ST, Zip Code:</p><p>Country:</p><p>Billing Notes: 1) Invoice (and credit card receipt, if applicable) will be sent to Purchaser. Please indicate whether you prefer invoice sent by Fax / Mail / Email 2) Credit card payments will be charged ten (10) days prior to event. 3) 25% cancellation fee applies to cancellations received within five (5) days of event.</p><p>4) Mail check payments to: American Governor Company Attn: Focus Class Registrations 27 Richard Road Ivyland, PA 18974</p><p>*Register by July 1st to receive $200.00 off your registration fee!</p>