Form Submission is restrictedYou have been successfully registered. Please make the payment via check or Zelle as soon as possible.Convention Registration Form newSponsor Level*Elite Visionary $50KDiamond Benefactor $25KPlatinum Patron $10KGold Guardian $5KNoneSelect a Package (The cost covers a 3-night stay, dinner on Friday, and meals throughout the day on both Saturday and Sunday)*Family (2 Adults and Kids) - $12502 Adults - $1050Individual - $800Souvenir Compliment (This price is available to registered AMICOS members only)Full Page $500Half Page $250File Upload Upload% Completed0First Name*Last Name*Phone*Email*Address*City*ZIP / Postal Code*State / Province / Region*Country*First NameLast NameAgeSelect GenderMaleFemaleRelationshipParentChildSpouseSiblingRelativeFriendColleagueGuardianPartnerOtherFirst NameLast NameAgeSelect GenderMaleFemaleRelationshipParentChildSpouseSiblingRelativeFriendColleagueGuardianPartnerOtherFirst NameLast NameAgeSelect GenderMaleFemaleRelationshipParentChildSpouseSiblingRelativeFriendColleagueGuardianPartnerOtherSelect Payment MethodCredit Card, Debit CardCheck or ZelleTotal Amount $ Submit
