Event Registration

	Automation Fair
	Event Registration

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Event Registration

Allen-Bradley Automation Fair

November 19-20, 2008 - Nashville, TN
Complete and submit the form below to register for one of the travel packages shown below. Please submit one completed form per individual attendee. Werner Electric will handle your registration for the event.

*indicates required field

Please select a package option:*

Package 1: $599.00
This package Includes airfare from Appleton to Nashville, 2 nights of hotel stay at the Renaissance Hotel, networking event at BB King’s, Automation Fair registration, and hands-on labs.
(Departing on November 18 and returning on November 20)

Sign up before May 30thand receive a $250 Werner Electric technical training voucher that can be used until Dec 31, 2009. More than 1 voucher can be used per training session.

Package 2: $200.00
This package includes hotel stay at $200 per night. You provide your own airfare arrangements. It also includes the networking event at BB King’s, Automation Fair registration, and hands-on labs. The Werner Electric training voucher is not offered with this package.

First Name*

Last Name*

Job Title

Department

Company Name*

Street Address*

City*

State*

Zip Code*

E-mail Address*

Phone Number*

Mobile Phone Number

Emergency Contact Name:

Emergency Contact Phone Number

Werner Sales Representative

Business Type

Job Level

Type of Industry

Preferred payment option
Purchase Order Credit Card Check Other

Upon submitting this information, you will be contacted by Amanda Marsicek (Werner Electric Supply) to finalize your trip and provide payment method. For more information, please contact Amanda directly at: 920-720-4010 or amarsicek@wernerelectric.com