I am Registering as a:
*
Recycler
Vendor/Sponsor
Other
Company Name:
*
Contact Name:
*
NC Dealer#:
For NC Dealer Continuing Education Certificate
Company Name as it Appears on NC Dealer License:
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is Your Estimated Participation in the Following Events:
This information helps CAR to better prepare for each event.
Number Attending Thursday Yard Tour:
*
Time & Location TBD in Winston-Salem
Number Attending Friday Night Dinner & Entertainment:
*
Number Attending Saturday Breakfast:
*
Summary of Fees & Payments:
* Vendors & Sponsors please complete and make payments based on your Vendor/Sponsor Application via online, download and mail or contacting Darlene Parker.
I am Including Payment/s for:
*
Annual Membership $200.00 (Includes 4 Attendees for all onsite events)
Additional Member-Guest Friday & Saturday ($50.00 Each)
Non-Member Guest Attending Friday & Saturday Events (150.00 Each)
Non-Member Guest Attending Saturday Only Events ($50.00 Each)
I am a Vendor/Sponsor and will pay via my Vendor/Sponsor Application
Other
I would like to pay:
*
now via secure Credit Card link below
via CAR calling for my CC Information
via CAR sending me a payment link via email
by mailing a check to CAR
at the Event
Contact Info for Credit Card Payments
Please enter phone# or email address if CAR is contacting you for CC payment.
Message to CAR
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