Welcome to the
2018 Annual Convention
Registration Form

Location:
Guest House at Graceland
Memphis,TN
June 28-29, 2018
(Optional events on June 27th)
Register!
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What's your first name? [Primary attendee] *

 
Thanks, {{answer_rTjS8t5XvY5b}}. What's your last name? *

 
Do you have any industry designations?

 
What name or nickname do you want on your badge?

 
With what company are you associated? *

 
Are you registering now for an exhibit booth for the trade show? *

     
 
View your options for exhibit booths choices and exhibitor information at: http://PIATN.com/exhibitor-1

 
First Booth Choice: *

 
Second Booth Choice:

 
Third Booth Choice:

 
Is there any company you would prefer your booth not be near in the trade show?

 
Please include a brief description of your company, products or services which will be included in the convention program. (35 words or less)

 
What is your current 2018 PIA Partnership level? *


 
Would you like to enroll as a 2018 PIA Partner now (as part of this registration)? *


 
Are you registering as a PIA Partner or Non-Partner? (check one)


 
Here is the current schedule for Wednesday, June 27th. Please check all events that you plan on attending.


 
Here is the current Thursday, June 28th schedule. Please check all that you plan on attending.

Please only make one selection per time slot.

 
Here is a current schedule for Friday, June 29th. Please select all that you plan to attend.

Please only make one selection per time slot. Please only make one dinner selection.

 
While we cannot guarantee pairings, is there a specific team, company or player(s) you prefer to play with?

 
Would you like to purchase a foursome for the golf tournament and save an extra $20?

     
 
Who are the other three players on your team? (include yourself in the list)

 
What is the street address you want listed in the materials?

 
City?

 
State?

 
Zip?

 
What's your office phone number?

 
What is your cell phone number? *

 
Based on your previous choices, what is your arrival date? *

 
What is your departure date? *

 
Will your spouse be attending?

     
 
What is your spouse's first name?

 
What is your spouse's last name?

 
How would your guest like their name to appear on their badge?

 
What is your guests cell phone number?

 
Here is the current schedule for Wednesday, June 27th. Please check all events that your guest plans on attending.


 
Here is the current schedule for Thursday, June 28th. Please check all that your guest plans on attending.

Please only make one selection per time slot.

 
Here is a current schedule for Friday, June 29th. Please select all that your guest plans to attend.

Please only make one selection per time slot. Please only make one dinner selection.

 
Will anyone else be attending from your Company or family who needs to be registered?

If your answer is 'yes' then please complete the following questions with their information.
     
 
Is this person registering for the entire convention, or just coming to assist with the exhibit booth on Thursday only? [Please Note: The Exhibitor Single Day Registration is only available in conjunction with an exhibit booth registration.] (check one):


 
Here is the current schedule for Thursday, June 28th. Please check all that this person plans on attending.


 
Here is the current schedule for Wednesday, June 27th. Please check all events that this person plans on attending.


 
Here is the current schedule for Thursday, June 28th. Please check all that this person plans on attending.

Please only make one selection per time slot.

 
Here is a current schedule for Friday, June 29th. Please select all that this person plans to attend.

Please only make one selection per time slot. Please only make one dinner selection.

 
What is this attendee's first name?

 
What's is this attendee's last name?

 
How would you like their name to appear on their badge?

 
What is their cell phone number? *

 
Based on your previous choices, what is this person's arrival date? *

 
What is their departure date? *

 
Will anyone else be attending from your Company who needs to be registered?

If your answer is 'yes' then please complete the following questions with their information.
     
 
Is this person registering for the entire convention, or just coming to assist you with the exhibit booth on Thursday only? [Please Note: The Exhibitor Single Day Registration is only available in conjunction with an exhibit booth registration.] (check one)


 
Here is the current schedule for Thursday, June 28th. Please check all that this person plans on attending.


 
Here is the current schedule for Wednesday, June 27th. Please check all events that this person plans on attending.


 
Here is the current schedule for Thursday, June 28th. Please check all that this person plans on attending.

Please only make one selection per time slot.

 
Here is a current schedule for Friday, June 29th. Please select all that this person plans to attend.

Please only make one selection per time slot. Please only make one dinner selection.

 
What this attendee's first name?

 
What's this attendee's last name?

 
How would you like their name to appear on their badge?

 
What is their cell phone number? *

 
Based on your previous choices, what is this person's arrival date? *

 
What is their departure date? *

 
Will anyone else be attending from your Company who needs to be registered?

     
 
How many additional Full Registrations will your group need [2018 Partners Only] | Price=$250?

 
How many additional Single Day Exhibitor Only Registrations will your group need [2018 Partners Only] | Price=$100?

 
How many additional Presidents' Dinner Tickets will your group need | Early-Bird Price=$85?

 
How many additional Golf Tournament Tickets will your group need | Early-Bird Price=$60?

 
...

 
Thank you. Press ENTER to continue to registration payment.

 
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Your current charge for the convention based on what you have entered above is {{var_price}}.


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Thank you for registering for the
PIA of TN Annual 2018 Convention.
We have your submission.

You should receive an email confirmation which includes details of this registration. If not, please contact the PIA office at (615) 771-1177.

To reserve your hotel room at The GuestHouse at Graceland, Click Below
RESERVE YOUR ROOM
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