Cultivating Quality in the Garden State



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47th Mid-Atlantic Quality Assurance Workshop

“Cultivating Quality in the Garden State”.

February 4 - 6, 2014

The Tropicana - Atlantic City, New Jersey

Attendee Registration


Company Name:



First Name:

.

Last Name:



Name as you want it to appear on name tag:



Address:



City:



State:



Zip Code:



Phone Number:



Fax Number:



Email Address:







Full Registration (Tuesday – Thursday)

Includes all Sessions, Tuesday Dinner Banquet, Wednesday Breakfast, Lunch and Reception, Thursday Breakfast, and Breaks




$185.00



Wednesday Registration

Includes all Sessions, Breakfast, Lunch and Breaks




$100.00



Tuesday Banquet Guest $50.00 per guest Guests


$



Special Meal(s) Required (vegetarian) Registrant Guest

No Charge



Payment Enclosed

$



Payment made with Credit Card (Visa or Master Card)

Receipt #:



$



Payment Information
Make Check Payable to: Mid-Atlantic QAW

Send Payment and Registration Form to:


Eileen C. Sheehy, P.E.

Manager, Bureau of Materials

New Jersey Department of Transportation

P.O. Box 600, Trenton, NJ 08625-0600

ph:  609-530-2307

fax:  609-530-5158

Email: registration@midatlanticqaw. com
If you prefer to pay by Credit Card, please visit www.midatlanticqaw.com and click on Registration. You must fax / email registration form after payment




Hotel Reservations (Not Included with reservation)
The Tropicana

2831 Boardwalk

Atlantic City, NJ 08401-6338

Phone: 1-800-345-8767



www.tropicana.net
Please specify you are attending the:

Mid-Atlantic QAW Hotel Code HQAW


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