CAI-NJ Jan. 2019 (w)

Sponsored By:

The Imperia: 1714 Easton Ave, Somerset, N J 08873 Registration/ C ocktail Hour: 6:00pm-7:00pm Dinner & Awards: 7:00pm-10:00pm Thursday, February 28, 2019

Registration Form

Payment options:

Name/Designation: _________________________________________________ Company:__________________________________________________________ Address:___________________________________________________________ City, State, Zip: _____________________________________________________ Phone: ____________________________________________________________ Fax: _______________________________________________________________ Email: _____________________________________________________________ Note: Ultimate Partners receive 4 tickets, Elite Partners receive 2 tickets and Premier Partners receive 1 ticket. _______ # of partnership tickets _______$150/ person OR _______ $1,400/ table (10 guests per table) Please list the name, company and designations of additional registrations. 2. _________________________________________________________________ 3. _________________________________________________________________ 4. _________________________________________________________________ 5.__________________________________________________________________ 6.__________________________________________________________________ 7.__________________________________________________________________ 8. _________________________________________________________________ 9.__________________________________________________________________ 10._________________________________________________________________

Make check payable to: CAI-NJ Mail completed form and payment to: Attn: Awards Dinner, CAI-NJ, 500 Harding Road, Freehold, NJ 07728 Pay by credit card: Please fax to: (609) 588-0040 or email to: jaclyn@cainj.org. Cardholder Name: __________________________________________ (as it appears on the card) Card Number: ______________________________________________ Exp. Date: __________ Security Code: __________________________ Cardholder Signature: _______________________________________ Cardholder acknowledges receipt of goods and/or services in the amount of the total shown here and agrees to perform the obligations set forth in the cardholder’s agreement with issuer.

TOTAL $____________________

*Cancellation Policy-Cancellations must be made by February 21, 2019 in order to receive a refund. Swaps can be made at any time.

For more information: email: Jaclyn@cainj.org or call: (609)588-0030