SCACS
Post Office Box 11405
Columbia, SC 29211

(803)-419-0804
Fax: (803)-419-4295

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SCACS Convention Registration

Please fill out ALL information below

For each attendee:

1. enter the Name that should appear on the Convention Badge
2. select an Attendee Type (Member, Non-Member, Spouse, Child, Teen, or Young Adult)
3. select the checkbox for each event desired for the Attendee (Golf, Tennis, etc)

If you need to submit information for more than 10 attendees, you will need to complete this form once for each 10 attendees or part thereof. You will receive a separate Confirmation Number each time you submit the form for a group of attendees.

Method of Payment
Credit Card Type
Credit Card Number
Expiration Date	Month / Year (enter the last two digits of the year)
Name appearing on card
Billing Address	Street City State Zip

Company Information
Company Name
Address
City
State
Zip
Telephone
Fax Number
Contact Name
Contact Title
Contact eMail
Verify Contact eMail


Name (to appear on Badge)	Member	Non-Member	Spouse	Child (3-11)	Teen (12-16)	Young Adult (17-21)
	$525	$650	Free	$200	$200	$200
	Fishing $175 Spouse Program $60 Tennis FREE Golf $135 Golf PacPack $40 Golf Shirt $50
	$525	$650	Free	$200	$200	$200
	Fishing $175 Spouse Program $60 Tennis FREE Golf $135 Golf PacPack $40 Golf Shirt $50
	$525	$650	Free	$200	$200	$200
	Fishing $175 Spouse Program $60 Tennis FREE Golf $ Golf PacPack $40 Golf Shirt $50
	$525	$650	Free	$200	$200	$200
	Fishing $175 Spouse Program $60 Tennis FREE Golf $135 Golf PacPack $40 Golf Shirt $50
	$525	$650	Free	$200	$200	$200
	Fishing $175 Spouse Program $60 Tennis FREE Golf $135 Golf PacPack $40 Golf Shirt $50
	$525	$650	Free	$200	$200	$200
	Fishing $175 Spouse Program $60 Tennis FREE Golf $135 Golf PacPack $40 Golf Shirt $50
	$525	$650	Free	$200	$200	$200
	Fishing $175 Spouse Program $60 Tennis FREE Golf $135 Golf PacPack $40 Golf Shirt $50
	$525	$650	Free	$200	$200	$200
	Fishing $175 Spouse Program $60 Tennis FREE Golf $135 Golf PacPack $40 Golf Shirt $50
	$525	$650	Free	$200	$200	$200
	Fishing $175 Spouse Program $60 Tennis FREE Golf $135 Golf PacPack $40 Golf Shirt $50
	$525	$650	Free	$200	$200	$200
	Fishing $175 Spouse Program $60 Tennis FREE Golf $135 Golf PacPack $40 Golf Shirt $50
Please double check all of the above information for accuracy and then click the submit button. Your total registration charges will be calculated from your selections on this page.

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