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87th Annual WCSA Convention
Personal Information
Please complete the form below to start the registration process.
When finished, please click on Other Information to complete your Registration.
* required field
* Salutation:
* First Name: * Surname
Position: * Nickname for Badge:
* Company or Organization:
* Address 1:
* City: * State/Province:
* Country: * Postal code:
* Telephone number: * Fax number:
Email address:
* Arrival Date: click * Departure Date: click
Other Information
Please complete the following information to assist us in meeting preparations.
Spouse/Guest Name: Nickname for Badge:
* Member Type:
Golf Attendees:
Member Handicap: (if applicable)
Spouse Handicap: (if applicable)
Please provide any comments below:
Comments:
Payment Details
Please supply your method of payment below. Registration Fee $250 USD.
Note that if you and/or your spouse plan to golf, this is $65 USD per person in addition to the registration fee.
If paying by credit card, please complete the Credit Card details fields.
* Payment type:
Name on Card: Card Number:
Exp. Date: - Auth. Code:
Sponsorship

For your sponsorship contribution you will receive: name recognition posted on the Western Cotton Shippers' Association website, name recognition on all the agendas and pamphlet handouts and each sponsor will be mentioned aloud during the general session.
I would like to sponsor the event in the amount of $ USD.

By ticking this box and submitting this form, you agree to pay the amount of $250 USD to the Western Cotton Shippers' Association for 1 (one) registration at the 87th Annual WCSA Convention.
CANCELLATION OR REFUND:

Registrants who are unable to attaend may notify the Western Cotton Shippers' Association on or before March 1st, 2010 for a full refund.