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"pet j" is an Indiana native and has graciously offered to let IMAS use her art on our site.


 


IMAS Open Party

June 12, 2010

REGISTRATION

 

Each individual that is attending must fill out this form.

 

***IMAS requires all individuals attending our events to provide the following information.  This information must come from your state supplied photo ID or Passport.  To gain entrance to the event you must present your state supplied photo ID or Passport and it must match the information provided on this form.

 

Once you register you will receive an email link to Paypal, where you can either pay with your PayPal account, credit card or debit card. (You don’t need a Paypal account to use credit card or debit card.)

*First Name:
Middle Name:
*Last Name:
Badge Name:
(The name you would like printed on your badge at the event. If left blank, no name will be printed.)
*Street Address:
*City:
*State:
*Zip:
*Is this registrant an IMAS member?
*Email address for sending event information:
*Verify event email:
Email address to send Paypal Invoice:
(If different from event email. Otherwise, leave blank.)
Verify Paypal email:

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