AICUP Member Meeting Corporate Affiliate Registration Form 2019
June 19-20, 2019
The Central Hotel & Conference Center, Harrisburg
Contact: Kelly at
#1 Registrant Name, Title, Email
#2 Registrant Name, Title, Email
Registration Options (check all that apply)
Individual #1 Registration ($275)
Individual #2 Registration ($275)
Vendor Table ($225) *Must also check Individual Registration
Dinner VIP Table ($400)
My company plans to participate in the Good Citizen Scholarship Raffle Fundraiser by contributing:
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