Procurement Seminar Print
Minority Procurement Seminar COMMITTEE ON HOUSE ADMINISTRATIONMINORITY PROCUREMENT SEMINARSeptember 27, 20078:00 a.m. to 5:00 p.m.Grand Hyatt Hotel  Registration Form (Please Print Clearly) 

Name__________________________________________________________________________

  

Ethnicity________________________________________________________________________

  

Address_____________________________City___________________State__________Zip____

  

Home Phone __________________________

 

Email Address______________________________

  

Business Name___________________________________________________________________

  

Business Address_____________________City____________________State________Zip______

  

Business Phone______________________ Fax________________ Email____________________

  

Type of Business_________________________________________________________________

   PAYMENT INFORMATION: The Charge is $50.00 per person.  (Please Check One) 

Visa______ MasterCard______ American Express________ Diners Club______ Discover________

 

Card Number____________________________

 

Card Expiration Date_____________

 

Card Billing Address _____________________________________________________

 

Your Signature__________________________________________________________

 Please Fax your Completed form to: (202) 226-2774.