Gemworld International, Inc.: WOGC Registration Form


	World of Gems Conference Registration
	September 13-14, 2008

NOTE: after you complete this form page, a results page will be displayed for review. You must click the "SUBMIT" button on the results page to place the order.

Registrant Information:

* Name
Company
Address
City
State
Country
Zip
* Phone
Fax
* E-mail
	All information on this form will be kept confidential. * marks required fields

World of Gems Conference:

Full Registration	$395.00
Gemworld or AGTA member	$345.00

Comments

Payment:

* Card Type	Visa MasterCard AMEX Discover
* Card Number
* Expiration Date
* CVV Code	Last three digits on the back of your card.
* Card Holder Name
All payment fields are required. This information will not be included in your confirmation email for your security.

IMPORTANT: The form results & total will be displayed on the next page. You must click the "SUBMIT" button on the next page to place your order.

If you prefer to mail this order form with your payment please print, complete and mail to:

Gemworld International, Inc.,
2640 Patriot Blvd, Suite 240
Glenview, Illinois 60026
USA
Ph: 847-657-0555 Fax: 847-657-0550

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