Angel Venture Fair

Investor Registration

Angel investors affiliated with an accredited angel group or network will receive a price discount as indicated below. Proof of affiliation with group is required. Attendance at cocktail reception is included in full ticket price. However, investors may attend the cocktail reception only for the price indicated below.

Member of Angel Network (see list of approved angel groups): $225 EARLY BIRD REGISTRATION through Mar 1st $275 March 2-April 10 $350 after March 13 or at the door * prices include ticket to "Bennies" Cocktail Reception	Independent/Non-Affiliated Angel Investor $275 EARLY BIRD REGISTRATION through Mar 1st $325 March 2-April 10 $400 after Apr 10 or at the door * prices include ticket to "Bennies" Cocktail Reception

$50 Bennies Only (open to all – investors, companies, service providers etc..)

	Full Name*
	Title
	Company Name
	Address*
	City*
	State/Province*
	Zip Code*
	Phone Number*
	Fax Number
	Email Address*
	Website URL
	Type of Registration*
	If other, specify:

	Affiliation*
	If Member, Then Which Angel Group?
	Other Angel Organization
	Industries of Interest
	Industry Experience
	Program Attendance*	April 21, 2008 4:00 pm Reception & Private Dinners OVERSUBSCRIBED Please contact us if you wish to be put on a waiting list. April 22, 2008 All Day Program (investors only. Price indicated above) April 22, 2008 “Bennies Only” $50(open to all –Entrepreneurs, Investors, Service Providers etc.. Price indicated above)
	Payment Amount*
	Type of Payment*
	Credit Card Type
	Name on Card
	Card Number
	Expiration Date
	Security Code
	Billing Address
	Billing City
	Billing State
	Billing Zip Code

I have read and are fully aware of the registration and cancellation policies for AVF.

Please Note: The charge will appear listed on your itemized credit card statement as "Angel Venture Fair."

Check
If paying by check, please complete the registration process online and mail your payment to the address listed below. Payment must be received prior to the event in order to qualify for the discount.

Make Check Payable to "Private Investors Forum"
Annual Angel Venture Fair – 2008
224 Pine Street, 3rd Floor Harrisburg, PA 17101
Tel: 717-238-1222 Fax: 717-238-9512
Email: vgaydos@51st.com