Order of the Engineer REGISTRATION AND ORDER FORM

Name: _______________________________________________________________________________ Address: _____________________________________________________________________________ City: ________________________________________ State: ____________ Zip Code: ______________ Telephone: ___________________________________________________________________________ E-Mail: ______________________________________________________________________________

ACEC 2018 Fall Conference Las Vegas, Nevada

METHOD OF PAYMENT: ____ Check (payable to ACEC) ___ MasterCard ___ Visa ___ American Express ___ Discover

Credit Card #: ______________________________________ Exp. Date: ______________ CVV#:_____

Name of Cardholder: ___________________________________________________________________

Authorized Signature: __________________________________________________________________ Further information is available by contacting: Daisy Nappier dnappier@acec.org Phone: 202-347-7474

ITEM QTY SIZE PRICE TOTAL

MEMBERSHIP & RING Indicate Quantity and Ring Size Price includes one ring and a certificate The tradition is that the ring is worn on the little finger of the working hand

$35.00

Please return form to Daisy Nappier by fax or email. dnappier@acec.org Fax: 202-898-0068