American Shorttrack Payment Credentials Form

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ASR Expo Shorttrack Technologies

American Shorttrack Payment Form

Company Name / Association

First Name

Last Name

E-mail Address

Web Site URL

Street Address

City

State/Prov

Zip/Postal Code

Country

Home Phone

Business Phone

Fax

Fee Description

	1. Expo Registration Fee
	2. Attendee FEE 2 day Black and White Badge ea. $20
	3. Golf Tournament Fee NA
	4. Think Tank Gold Card Badge Attendee Fee ea. $50
	5. Additional Think Tank attendee White and Blue Badge ea. $50
	6. Shorttrack Legends w/meal Ticket/ WristBand ea. $30
	7. Shorttrack Legends w/out Meal Ticket/ Wristband ea. $10
	8. Daily Expo and New years Eve Party Ticket/ Wristband ea. $10
	9. Gold Card Badge ea. $40
	10. Vintage Race Car Gold Card Badge Entry Fee W/Meal $40
	11. Street Rod Car Show Gold Card Badge Entry Fee w/Meal $40
	12. Additional Vintage or Street Rod one day pass w/out meal ea. $10
	13. ASR Expo Store Merchandise
	14. Jalopy Beer Merchandise
	15. Racers Swapmeet and Car Show one day pass per space $20

Type of Payment

	1. Check
	2. Visa
	3. MasterCard
	4. Amex

Gold Card Badge includes; Seven Day Pass into ASR Expo, New Years Eve Party, Legends Shorttrack Presentation w/Meal, and Two Day Pass into the Roger McCluskey Ford Focus Midget Western Nationals at Tucson Raceway Park!

Red and White or Blue and White Card Badges include the same as a Gold Card Badge, as an additional person to the Gold Card Badge!

Wrist Band entry into the ASR Expo, Legends Presentation, New Years Eve Party, and the Roger MCluskey Ford Focus Western Midget Nationals at TRP are for one day entry!

Saturdays Jan. 2nd, 2009 ASR Expo Wrist Band also includes Legends Presentation w/out Meal for $10!

Make Checks out to.... ASR Expo LLC

Please fill out form then SUBMIT form with Signature, send check, and mail TO;

American Shorttrack Expo LLC / P.O. Box 91377 Tucson, Arizona 95752

If paying by Credit Card please click on Purchase Now button for secured Credit Card Payment.

ASR Expo Shorttrack Technologies

Make Checks out to.... ASR Expo LLC

If paying with Credit Card or Debit Card, make all payments here, please use the box below with the total Dollar amount!