First Name:
Last Name:
Organization:
Address Line 1:
Address Line 2:
City:
State (abbrev):
Zip Code:
Phone:
E-mail Address:
Registration Quantity & Type:	Qty:    Table of 8  $360.00 Individual Seat(s)  $50.00 Diamond Blue Ribbon Sponsors 6 Seats  $0.00 Blue Ribbon Sponsors 4 Seats  $0.00 Red Ribbon Sponsors 3 Seats  $0.00 White Ribbon Sponsors 2 Seats  $0.00 Special Ribbon Sponsors 1 Seat   $0.00
Please list the FIRST & LAST NAMES of each member of your party.:
Commemorative Event Booklet Advertising:	Full Page Ad @  $125.00 1/2 Page Ad @  $75.00
Text for commemorative booklet ad :
Email JPEG ad graphics to info@kgaonline.org (2mb limit) & provide filename in space at right:
Payment Method	Credit Card Check or Money Order