wwwcga Convention Headquarters

Greenville Auction Center
5239 ST. RT. 49S MAP IT
Greenville, Ohio

August 10-13, 2011

Convention Registration Form
Please fill out the form below as completely as possible. Please use first and last names of all attendees. Additionally, please print this page once it is filled out before pressing SUBMIT. When sending in your check, please include a copy of this page properly filled out.

Name of first attendee (as you would like it on your badge):
Name of second attendee (as you would like it on your badge):
Name of third attendee (as you would like it on your badge):
Name of fourth attendee (as you would like it on your badge):

Mailing Address:

City/State/Zip (Postal Code):

Country:
Telephone:

E-mail Address:

Check the events below you believe you will be attending:
Golf Tournament (Wednesday, add'l $22.00) Banquet (Friday) Auction (Saturday)
Check here if you plan on bringing glass to sell in the sale.
Convention Registration (per person) @ $20.00 = $

TOTAL = $

Note: If not in the United States, the prices are as follows:
United Kingdom: Registration - £10.00
Canada: Registration - $20.00 CDN
Australia: Registration - $22.00 AUS

Please print this page and then
click on Submit button,
then send check for TOTAL indicated to:
www.cga, inc.
Brian Pitman
10750 NW 13th St.
Topeka, KS 66615
(This information will be on the confirmation page)

Members in England, Canada or Australia may send registration payment to their local Ambassadors. All other foreign members should submit payment in U.S. Dollars through International Money Orders.