2015 Conference Registration Name* First Last Company/Organization*Title*Address* Street Address City State Zip Phone*Email* Conference Registration Fee*MAGiC Member ($110)Non-Member ($135)Total Due $0.00 Credit Card Payment DiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name CommentsThis field is for validation purposes and should be left unchanged.