2022 Coral Gables Convention Registration

2022 SSA Convention Coral Gables

October 11th through 13th
CONTACT INFORMATION
Full Name: *

First Name Last Name
Nickname:
Nickname
Company Name: *
Job Title:
Phone Number *
Please provide your preferred contact phone number.
Email *
Type of Registration (Please choose ONE option per delegate. Each delegate must fill out a unique registration form.) *

Repair Shop - Primary Delegate Repair Shop - Secondary Delegate Supplier Registration - All Delegates
Company Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Will a spouse/guest be attending? (Cost is $200.00)

Yes No
Will you be bringing more then one guest? If yes, we will be in touch with you for contact information and additional pricing.

Yes No
CONTACT INFORMATION FOR SPOUSE/GUEST:

First Name Last Name
Nickname:
Nickname:
Phone Number
Please enter a phone number.
CLOSING RECEPTION DINNER OPTIONS - 10/13/22:

The closing reception will be held on Thursday October 13th at 6:30
Please choose one of the following dinner entrees: *

Filet Mignon Coriander Crusted Corvina Chicken Breast I will not be able to attend.
Please choose one of the following dinner entrees for your spouse/guest: *

Filet Mignon Coriander Crusted Corvina Chicken Breast I will not be able to attend.
GOLF OUTING - 10/11:

The golf outing will be on Tuesday, October 11th with an 10:00 EST start time at the Biltmore Golf Course in Coral Gables.
Will you be golfing on Tuesday October 11th? (COST is $195.00)

Yes No
If yes, please choose your golf outing Boxed Lunch (Chips, country potato salad and macadamia white chocolate chip cookie included.)

Italian sub with cured ham, provolone cheese, genoa salami& marinated onions Roast turkey on a baguette, lettuce & tomato Greek salad wrap, cool crisp greens, cucumber, tomato, feta cheese, kalamata olive spread & herb oil
Will your spouse/guest be golfing on Tuesday October 11th? (COST is $195.00)

Yes No
If yes, please choose your golf outing Boxed Lunch for your spouse/guest (Chips, country potato salad and macadamia white chocolate chip cookie included.)

Italian sub with cured ham, provolone cheese, genoa salami& marinated onions Roast turkey on a baguette, lettuce & tomato Greek salad wrap, cool crisp greens, cucumber, tomato, feta cheese, kalamata olive spread & herb oil
Will you need to rent golf clubs? (COST is $76.50)

Yes - Right Handed Yes - Left Handed No
Will your spouse/guest need to rent golf clubs? (COST is $76.50)

Yes - Right Handed Yes - Left Handed No
Miami Vice Boat Tour Friday 10/14/22:

Ride Miami’s only boats that provides sightseeing + attraction altogether! During this 45-minute Speedboat tour, you are provided with an ultimate sightseeing experience of Biscayne Bay, City of Miami Beach, Fisher Island, and a tour of the Mansions on Star Island. Be ready to take pictures of the beautiful Downtown Miami Skyline.
Will you be attending the Miami Vice Boat Tour Friday 10/14/22? (COST is $50.00)

Yes No
Will your spouse/guest be attending the Miami Vice Boat Tour Friday 10/14/22? (COST is $50.00)

Yes No
Would you be interested in a tour of our member shop Rose Spring?

Yes No
TOTAL COST: $
Email - Your invoice will be emailed to this address. *

Confirmation Email Please enter your email twice to be sure we get it right.
Your invoice will be sent instantly to the address above once you click Submit. Please look for that email from noreply@jotform.com.

Please send payment to:

Service Specialists Association

C/O Toni Nastali

1531 Springside Place

Downer's Grove, IL 60516
Should be Empty:

2022 SSA Convention Coral Gables

CONTACT INFORMATION

CLOSING RECEPTION DINNER OPTIONS - 10/13/22:

GOLF OUTING - 10/11:

Miami Vice Boat Tour Friday 10/14/22: