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 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name PhoneThis field is for validation purposes and should be left unchanged.