2021 WMCA Convention Registration (credit card) | Wisconsin Motor Carriers Association Online Payment

Name*

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Company

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone

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I Would Like To...

Register for Both Days
Register for Day 1
Register for Day 2
Register as a Haul of Fame Member

Thank You! Your registration is complimentary. (Enter '1' in the Quantity box below)

Price: $0.00 Quantity:

Is Your Company a Diamond Club Member?

Yes, we are Diamond Club Members
No.

Diamond Club members receive two (2) complimentary passes. Club members are HNI, JJ Keller, CliftonLarsenAllen, EH Wolf and Sons, Kriete Truck Centers, Pre-Pass, Truck Country, North Central Utility, Baker Tilly and UPS.

Thank You! Two of your registrations are complimentary.

Price: $0.00 Quantity:

Name of Complimentary Attendee

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Name of Complimentary Attendee

First Last

Would You Like to Register Anyone Else?

Yes
No

Name of Additional Convention Attendee

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Select One

Register for Both Days
Register for Day 1
Register for Day 2

Name of Additional Convention Attendee

First Last

Select One

Register for Both Days
Register for Day 1
Register for Day 2

Name of Additional Convention Attendee

First Last

Select One

Register for Both Days
Register for Day 1
Register for Day 2

Register for Both Days (enter number of people)

Price: $100.00 Quantity:

Register for Day 1 (enter number of people)

Price: $25.00 Quantity:

Register for Day 2 (enter number of people)

Price: $125.00 Quantity:

Would You Like to be a Sponsor?

Yes
Not this year

Please Select a Sponsorship

Platinum - $1,000
Gold - $750
Silver - $500
Bronze - $250
Opening Night Appetizers - $1,500
Buffet Breakfast - $1,500
Chairman's Reception - Host Bar - $2,000
Chairman's Reception - Appetizers - $1,500

Platinum Sponsor

Price: $1,000.00 Quantity:

Platinum Sponsors Receive (2) Both Day Tickets - If Attendee is unknown please fill in as "Guest"

Name of Convention Attendee

First Last

Name of Convention Attendee

First Last

Gold Sponsor

Price: $750.00 Quantity:

Gold Sponsors Receive (1) Both Day Ticket - If Attendee is unknown please fill in as "Guest"

Name of Convention Attendee

First Last

Silver Sponsor

Price: $500.00 Quantity:

Silver Sponsors Receive (1) Single Day Ticket [of their choosing] - If Attendee is unknown please fill in as "Guest"

Name of Convention Attendee

First Last

Single Day Ticket Choice

Day 1
Day 2

Bronze Sponsor

Price: $250.00 Quantity:

Opening Night Appetizers

Price: $1,500.00 Quantity:

Breakfast Buffet

Price: $1,500.00 Quantity:

Chairman's Reception - Appetizers

Price: $1,500.00 Quantity:

Chairman's Reception - Host Bar

Price: $2,000.00 Quantity:

Billing Address*

Street Address Address Line 2 City State ZIP Code

Secure Credit Card

Card Holder*

Card Number*

Card Expiration*

Card CVV*

Transaction Fee*

Price: $5.00

Total

$0.00