REGISTRATION FORM

NCMA Greater Philadelphia Chapter

In collaboration with the National Defense Industrial Association (NDIA)

Delaware Valley Chapter

Are pleased to present:

Department of Homeland Security Procurement Innovation Lab (PIL) Seminar

Date: Tuesday November 29, 2016

Duration: 4:30 pm - 8:30 pm Check-in Time: 4:30 pm - 5:00 pm

Dinner will be served.

Register Now! / Location
Email:
Subject: DHS PIL Seminar Registration
Fax: (215) 343-1003
Attn:DHS PIL Seminar Registration Greater Philadelphia Chapter
Mail:NCMA Greater Philadelphia Chapter, c/o Susan Beal, 865 Easton Rd., Suite 300, Warrington, PA18976 / Naval Support Activity
Fran’s Hangar Bay Club, Bldg. 15
700 Robbins Ave.
Philadelphia, PA 19111
Participant Information - Print ClearlyUpdate my contact information
Name: / NCMA Member #:
Title:
Organization:
Address: / (W/H) / Suite/Apt.#:
City: / State, Zip:
Phone Work: / ( ) - / Fax: / ( ) -
E-mail: /  Required for confirmation
Emergency Contact: / EC Phone:
Check here if you require special assistance or have special meal requirements
Registration Fees(includes dinner and a complimentary cocktail)
Regular (by COB November 23 , 2016)
NCMA/NDIAMember & Govt. Employee Price: $38.00
 Non-Member Price: $ 55.00
Payment Method
Check Enclosed: / Payable to NCMA Greater Phila. Chapter / Check No.:
Credit Card: /  VISA / MasterCard
Total Charge Amount: / $
Card Number: / Exp. Date:
CSC Code
(from Credit Card) / Credit Card
Billing Zip Code:
Name on Card: / Signature:

Payment must be made at the time of registration.All proceeds go to the NCMA Greater Philadelphia Chapter. The chapter accepts MasterCard, Visa and personal/company checks. NCMA does not accept purchase orders or requests for invoicing. Registrations must be received by November 23, 2016 (5:00 PM ET). If not received by November 23, 2016 (5:00 PM ET), you must register on site. Space is limited, please plan accordingly. For planning purposes, please contact Susan Beal if you intend to register onsite. Each individual must complete a separate registration form.

Cancellations, Substitutions, and Requests for Refunds

All cancellations, substitutions, and requests for refunds must be submitted in writing. Substitutions are welcome! Registrants who are unable to attend the seminar must fax or e-mail their cancellation or refund request to the attention of NCMA Greater Philadelphia Registrar Susan Beal (215) 347-1459, , on or before November 23, 2016(5:00 PM ET). A $30 administrative fee will be applied to all cancellations received before November 23, 2016(5:00 PM ET). No refunds will be issued for cancellations received after November 23, 2016(5:00 PM ET). Refunds will not be issued for no-shows. Additional inquiries, contact the registrar at (215-347-1459).