Online Registration

Please fill up the following form to register for the First Biennial Meeting and Reunion in Las Vegas, Nevada on June 25, 2016.

Registration Form

Name (Last, First, MI)(required)

Street Address(required)

City(required)

State(required)

Zip Code(required)

Country(required)

Email (Your receipt will be emailed to you.)(required)

Phone(required)

Year of Graduation(required)

Total Payment (Add the amounts in Bill #1 and Bill #2)(required)

For those bringing guests to the dinner program, please list down the name and age of each guest. For those bringing an alumnus spouse, please write his/her name, the degree and year of graduation. If not bringing one, please type in "NA" for not applicable. Note: Age 2 and under are free. Ages 3-10 have 50% discount ($37.50). Ages 11 and up are full price of $75. Please make the necessary adjustment when you enter your Total Payment above.(required)

Paying by Credit Card

If paying by credit card, please follow the link to PayPal. You will need to enter the Total Payment indicated above.

Paying by Check

If paying by check, please write a check for the Total Payment indicated above payable to USAPMTIAA. Your registration will be processed once check is received. Please mail the check to:

Ednie A Mckeehan
USAPMTIAA Treasurer
7645 W Arndt Ct
Laporte, IN 46350
USA

Thank you for registering for the First Biennial Meeting and Reunion in Las Vegas. See you there!

Notes

Registration fee is valid until March 31, 2016. By April 1, 2016, the registration fee changes to $175 for Active Members and $200 for Non-Active Members.

USAPMTIAA is a 501(c)3 organization. Any donation you send to USAPMTIAA is tax-deductible.