Student Career Day – Indianapolis, IN « Hot Rod Car Show, Custom Car Shows, Bobbers, Customs, Summit Show Car Series – Autorama / World of Wheels / Cavalcade of Customs

Indiana State Fairgrounds: February 8, 2013 (9:30am)

TO PAY BY CREDIT CARD:

Complete the REGISTRATION FORM below and click SUBMIT at the bottom of the form. A copy of your registration will be emailed to you and to Student Career Day Headquarters where your credit card transaction will be processed.

TO PAY BY CHECK:

Complete the REGISTRATION FORM below and click on SUBMIT at the bottom of the form. A copy of your registration will be emailed to you and to Student Career Day Headquarters. Print a copy of the email and mail it along with your check to:

Championship Auto Shows, Inc.
Attn: Student Career Day Registration
1092 Centre Road
Auburn Hills, MI 48326

Registration DUE DATE: FEBRUARY 1, 2013

STUDENT CAREER DAY REGISTRATION FORM - INDIANAPOLIS, IN

School Information

Name of School *

# of Buses Arriving *

School Address *

Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Contact Information

Contact Name *

Contact Phone *

Contact Email *

Student / Chaperone Count

# of Students & Chaperones w/Lunch$15.00/each

# of Students & Chaperones w/o Lunch$10.00/each

TOTAL AMOUNT DUE $ *

Instructions(1) Wristbands will be made available for pickup at the Student Career Day Registration table one hour prior to program start. The program starts at 9:30am. Please plan to arrive early to allow time for registration. (2) Wristbands should be picked up and distributed at the Pepsi Coliseum. Door will be marked “Education Day”. Bus parking is located on the SE corner of the Blue Ribbon Pavilion (38th & Fall Creek area). Suggested student pick-up is outside the main entrance of the Blue Ribbon Pavilion. (3) For program and payment related inquiries, please contact Sue Christophersen by email schristophersen@autorama.com or call (248) 373-1700.

Payment Info (No Refunds)

Payment Method *
Check Credit Card (Visa, Mastercard, AMEX)

Credit Card Payment Information

Name on Card

Card NumberEnter as (i.e. 5555-5555-5555-5555).

Exp. Month / YearExample, enter "January 2012" as "0112". EXCLUDE "/" or "-".

Security Code(3) Digit Code on the Backside of the Credit Card.

Billing Address

Billing City

Billing State

Billing Zip Code

Additional Comments

Verification

Please enter any two digits with no spaces (Example: 12) *
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