Underground Construction - December 2017 - 62

Underground Construction Technology
International Conference & Exhibition

Register today at
uctonline.com!

Register using this form or online at uctonline.com

Check which best describes
your title (check one only):

One form per registrant. Confirmations and receipts will be emailed
Questions/Information, email: Karen E. Francis at kfrancis@uctonline.com

1

o
o
o
o
o
o
o

Name: ____________________________________________________________________________________
Business Title: ____________________________________________________________________________

Owner/Pres./Director
Engineer
Field Operations
Vice Pres./Sr. Management
Supervisory Personnel
Marketing/Sales
Editorial/Press

Company: _________________________________________________________________________________

Indicate company type
(check one only):

Address: __________________________________________________________________________________

o
o
o
o
o
o
o
o
o

City: _____________________________________________________ State/Province: ___________________
Zip/Postal Code: __________________________________________ Country: ________________________
Phone:______________________________________ Fax: __________________________________________

(sewer/water/storm)

Email: ___________________________________________________________________________

o
o
o

(required for confirmation)

Is this your first time attending UCT?

o Y o N If No, how many times___________

What is your involvement in company purchasing decisions? o Approve o Recommend o Not involved

Select a registration option.
To qualify for the Bring
The Company special rate,
ALL registrants must be from
the same company and must
be registered at the same time.
Substitutions are allowed.
If registering for one of the CUIRE
or NASSCO specialized training
programs contact the facility.

One Registrant

UCT Primary Program,
Jan. 30 - Feb. 1, 2018

2 - 25 Registrants

Regulator/Government
Rental Company
Utility Companies
(electric, energy pipeline,
gas distribution, industrial, telecom)

What is the #1 reason you attent UCT? o Continuing Education o See Equipment o Networking

2 REGISTRATION

Gas Distribution
HDD
Pipeline/Energy
Plumbing
Sewer/Water
Telecom/Electric/Cable
Engineering
Manufacturer/Supplier
Public Works

o
o

Association
Media

26 - 50 Registrants

Thru
Jan. 8

After
Jan. 8

Thru
Jan. 8

After
Jan. 8

Thru
Jan. 8

After
Jan. 8

$395

$495

$495

$595

$895

$995

Choose day:
o Tuesday o Wednesday o Thursday

$215

$295

$275

$375

$495

$595

Exhibits Only

Free

N/A

N/A

Full Conference 3 Days
Full Conference 1 Day

$25

N/A

N/A

CUIRE Training Schools - Email: cuire@uta.edu
NASSCO PACP Courses - Email dawn@nassco.org
Grand Total

3 PAYMENT OPTIONS - Full payment is required
o Pay By Check
If paying by check, make
check payable to UCT
and send it with the
completed application to:
UCT Gulf Publishing Co
PO Box 2608
Houston, TX 77252-2608

Total

$

Today's Date:______________ Total amount due: ______________

If paying by credit card, complete section below and fax to 713-520-4450.
Receipts and registration confirmation will be emailed.
o MasterCard

o Visa

o AMEX

o Discover

Card number: _____________________________________________________________________________________________
Expiration Date: _______________________ CVV Code: _______________________
Name on card: ____________________________________________________________________________________________
Signature: _______________________________________________________________________________________________
Provide billing address if different from section 1
Address: _________________________________________________________________________________________________
City, State, Zip_____________________________________________________________________________________________

Cancellation Policy:
No refunds on the Bring The Company Rate or exhibit hall fees, substitutions are allowed. If only one (1) individual from a company registers, the following cancellation policy applies 100%* refund if cancelled in writing by Jan. 8, 2018. No refunds after COB Jan. 8. Substitutions are allowed.
Email cancellations to kfrancis@uctonline.com.*$5 admin fee to be deducted from all refunds.

62

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Underground Construction December 2017
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Underground Construction - December 2017

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