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 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Expiration Date Security Code Cardholder Name PhoneThis field is for validation purposes and should be left unchanged.