American Shotcrete Association

NY NY Las Vegas

Twelfth Annual Outstanding Shotcrete Project
Awards Banquet Registration Form

Early Bird Registration ($95) until December 29, 2016
Pre-Registration ($150) until January 16, 2017
Limited Onsite Registration Available ($175) - January 17, 2017

Join us in celebrating another year of membership success and in recognizing our Project Award recipients.
Submit one form per company. We look forward to seeing you in Las Vegas!

Banquet Information:
Location: Vdara Hotel & Spa | Vinoly Ballroom
Date: Tuesday, January 17, 2017
6:00 - 7:00PM: Registration, networking, cocktails, and Hors d'oeuvres
7:00 - 11:00PM: Plated dinner, awards ceremony, followed by cash bar networking reception

If you have any questions or experience any problems completing this form,
please contact us at or via phone at (248) 848-3780

Company Name*:








Zip Code*:








Company, if different from Submitting Company

Attendee Name(s):
Required by 1/27/16 for badges to be available at reception. Can be emailed to







Banquet Sponsorship Opportunity:

For inclusion in full benefits submit by November 30, 2016

All sponsor levels will be acknowledged at the Awards Banquet, in the ASA Booth during the 2016 World of Concrete, on the ASA website, in an ASA Awards Press Release and in Shotcrete magazine. Please email a high ressolution .eps or .jpg file of you company logo by November 30, 2016 to

How many tickets would you like to purchase?*:


This is a secure document. Any information you enter will be digitally signed and encrypted (scrambled) for privacy while in transit.

We accept:
Name on card:
Card number:
Expiration date:
Card CVV:

* Required Fields