2023 Burlington Vermont Convention Registration

2023 SSA Convention Burlington Vermont

October 3rd through 5th Hilton Burlington Lake Champlain
CONTACT INFORMATION
Full Name:*

First NameLast Name
Nickname:
Nickname
Company Name:*
Job Title:
Phone Number*
Please provide your preferred contact phone number.
Email*
ORDER YOUR SSA ZIP UP FLEECE JACKET!
We have a special treat this year. Please fill out the following for your SSA zip up fleece sponsored by HENDRICKSON! Also, please register before SEPTEMBER 1ST to ensure we have time to make your jacket.

MensWomens
Mens zip up fleece jacket size

SMLXLXXLXXXL4XL5XL
Womens zip up fleece jacket size

XSSMLXLXXLXXXL
TYPE OF REGISTRATION
(Please choose ONE option per delegate. Each delegate must fill out a unique registration form.)*

Repair Shop - Primary DelegateRepair Shop - Secondary DelegateSupplier Registration - All Delegates
Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Will a spouse/guest be attending? (Cost is $400.00)

YesNo
Will you be bringing more then one guest? If yes, we will be in touch with you for contact information and additional pricing.

YesNo
CONTACT INFORMATION FOR SPOUSE/GUEST:

First NameLast Name
Nickname:
Nickname:
Phone Number
Please enter a phone number.
Please fill out the following for your guests SSA fleece jacket sponsored by HENDRICKSON. PLEASE NOTE>>> This option is no longer available as of 8/31/23

MensWomens
Mens zip up fleece jacket size for guest

SMLXLXXLXXXL4XL5XL
Womens zup up fleece jacket size for guest

XSSMLXLXXLXXXL
CLOSING RECEPTION DINNER OPTIONS - 10/5/23:

The closing reception will be held on the evening of Thursday October 5th
Please choose one of the following dinner entrees:*

Filet MignonStuffed Filet of Sole with Scallop MousseMaple Glazed Chicken BreastI will not be able to attend.
Please choose one of the following dinner entrees for your spouse/guest:*

Filet MignonStuffed Filet of Sole with Scallop MousseMaple-Dijon Glazed Chicken BreastI will not be able to attend.
GOLF OUTING - Rocky Ridge Golf Club

The golf outing will be on Tuesday, October 3rd with an 9:00am start time at the Rocky Ridge Golf Club in St. George VT. NOTE: Golf club rentals are very limited and first come first served. Please bring your own set of you are able.
Will you be golfing on Tuesday October 3rd? (COST is $125)*

YesNo
If yes, please choose your golf outing Boxed Lunch*

HamTurkey
All clubs have been rented at this point. Please bring your own clubs or be willing to share with someone else.

Yes option is no longer available.No
Will your spouse/guest be golfing on Tuesday October 3rd? (COST is $125)*

YesNo
If yes, please choose your golf outing Boxed Lunch for your spouse/guest.*

HamTurkey
Spirit of Ethan Allen lunch cruise 10/4/22:

As of 9/10/23 tickets have been ordered. Please contact us directly at GookinBrand@gmail.com to see if we can add any more seats.
Spirit of Ethan Allen lunch cruise? (COST $80)

Yes option is no longer availableNo
TOTAL COST: $
Email - Your invoice will be emailed to this address.*

Confirmation EmailPlease enter your email twice to be sure we get it right.
Your invoice will be sent to the address above once it has been processed. Please look for that email from toni@spring-align.com.

Payment may be mailed to:

Service Specialists Association

C/O Toni Nastali

1531 Springside Place

Downer's Grove, IL 60516
Should be Empty:

2023 SSA Convention Burlington Vermont

CONTACT INFORMATION

ORDER YOUR SSA ZIP UP FLEECE JACKET!

TYPE OF REGISTRATION

CLOSING RECEPTION DINNER OPTIONS - 10/5/23:

GOLF OUTING - Rocky Ridge Golf Club

Spirit of Ethan Allen lunch cruise 10/4/22: