SAPCC Annual Representatives’ Meeting & Lunch Registration Fort Worth, TexasWednesday, July 21, 2021Annual Representatives’ Meeting & Lunch Registration Lunch Prices are subject to change without notice. The Fort Worth Cake Expo Committee is looking forward to being your host at the Annual Representatives Meeting and Representatives Lunch, we hope that you will be able to attend Both Events. To help us plan for this event, please complete the following information.Your InformationS/A/P/C/C Name:Your Name:* First Last Phone:*Alt Phone::Email* Enter Email Confirm Email Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Representatives Meeting AttendanceMy ICES position is:*Choose your positionGeneral MemberRepresentativeActing RepresentativeAmbassadorBoard of DirectorsInterim ICES RepresentativeMembership CoordinatorRepresentative ModeratorRepresentative SecretaryExpo CommitteeYou qualify for a Complementary Representatives' Lunch.Before completing this form please verify that your S/A/P/C/C Representative/ Ambassadorcompleted the Acting Representative form giving you permission to act in their absence. Failure to do so will affect any reimbursements and Complimentary Luncheon eligibility.Verification* Yes, I have been verified as Acting Representative for my S/A/P/C/C.General Member Representatives LunchWould you like to attend the Representatives Lunch?Yes, and agree to the $40 paymentNo thank youII will be paying by:*Credit CardCheck - MailingComplimentary Representatives Lunch SignupIf you need to cancel your Complementary Representatives' Lunch, you must notify Representation@ices.org before July 15, 2021 or you will be sent an Invoice of $40.00 (Forty USD).Will you be joining us for the Complimentary Representatives Lunch?*Yes, I will.No, I will not.Payment Options Please make checks payable to ICES Please mail checks to: Helen OsteenICES Membership Coordinator2502 Esther AvePasadena TX 77502-3239Total $0.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Please SubmitThis form is not complete unless you click “submit" and will be used as your digital signature. Once you have submitted the form you should receive a “Thank You” confirmation email. If you do not receive this “Thank You” email then your form DID NOT go through and you will need to RE-SUBMIT your form. Please double check to make sure you: Have filled in all the required information, (a RED message will appear if information is missing).Este formulario no está completo a menos que haga clic en "enviar".Una vez que haya enviado el formulario, debe recibir un correo electrónico de confirmación de "Gracias". Si no recibe este correo electrónico de "Agradecimiento", entonces su formulario NO se envió y tendrá que REITERAR su formulario.Por favor, vuelva a verificar para asegurarse de que:Ha completado toda la información requerida (aparecerá un mensaje ROJO si falta información).PhoneThis field is for validation purposes and should be left unchanged.
