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HomeMy WebLinkAbout229555 2/25/2014 CITY OF CARMEL, INDIANA VENDOR: 368009 Page 1 of 1 ONE CIVIC SQUARE LEWISVILLE FIRE DEPARTMENT a CARMEL, INDIANA 46032 KTA SYMPOSIUM CHECK AMOUNT: $650.00 o�aPO BOX 299002 CHECK NUMBER: 229555 LEWISVILLE TX 75029-3704 CHECK DATE: 2/25/2014 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4357004 650 . 00 EXTERNAL INSTRUCT FEE Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me if you wish to pay via credit card. I will call you to complete the registration. 2014 KTA Symposium rRegastratoon The 2014 Registration fee for KTA is$65 per attendee. Checks can be made payable to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to use a credit card please include a daytime phone number and I will contact you to get the necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR PAYMENT! Each participant MUST complete the form. Please choose between Pipes and Drums or Honor Guard but not both. Name Department Name 2 ,C_L 1�12 6- Department City ;.►� Department State Cell Phone J — Email Address 11-7 u . Please circle the appropriate response: What are you signing up for (Please Only Choose One) Honor Guard Honor Guard Commander Team Member P RE B gi ntermediate Advanced**** ****Advancedla ers will be required to audition for this group on day one P Y Drums Snare Tenor Bass Beginner Intermediate Advanced Will you require transportation from the airport �e - No We are happy to provide transportation to and from DFW or Dallas Love Field. We will require your complete itinerary for arrival and departure flights. We also need a cell phone number that you will have with you while traveling to coordinate your transportation. Flight Information _ Arrival Airline Flight Number Arrival Date and Time � Departure Airline Flight Number Departure Date and Time Mail completed registration and payment to: Lewisville Fire Department Attn: KTA Symposium PO Box 299002 Lewisville, TX 75029-3704 Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me if you wish to pay via credit card. I will call you to complete the registration. 2014 KTA Symposium Rlegistratbn The 2014 Registration fee for KTA is$65 per attendee. Checks can be made payable to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to use a credit card please include a daytime phone number and I will contact you to get the necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR PAYMENT! Each participant MUST complete the form. Please choose between Pipes and Drums or Honor Guard but not both. Name Department Name Department City „12. Department State Cell Phone 217 - �//� �1Z Email Address fie/ Q .`.e . -Alv Please circle the appropriate response: What are you signing up for (Please Only Choose One) Honor Guard Honor Guard Commander Team Member Pipes Beginner Intermediate Advanced"" ""Advanced players will be required to audition for this group on day one Drums Snare ' enor ass ginner Intermediate dvanced Will you require transportation from the airport Yes Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me if you wish to pay via credit card. I will call you to complete the registration. 2014 KTA Symposoum 'Registration The 2014 Registration fee for KTA is$65 ver attendee. Checks can be made payable to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to use a credit card please include a daytime phone number and I will contact you to get the necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR PAYMENT! Each participant MUST complete the form. Please choose between Pipes and Drums or Honor Guard but not both. Name Department Name c� Q Department City Department State Cell Phone Email Address Please circle the appropriate response: What are you signing up for (Please Only Choose One) or Guard onor Guard Commanders Team Member Pipes Beginner Intermediate Advanced"" ""Advanced players will be required to audition for this group on day one Drums Snare Tenor Bass Beginner Intermediate Advanced Will you require transportation from the airport Yes jfVoy Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me if you wish to pay via credit card. I will call you to complete the registration. 2® 14 KTA Symposoum Rlegostratbn The 2014 Registration fee for KTA is$65 per attendee. Checks can be made payable to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to use a credit card please include a daytime phone number and I will contact you to get the necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR PAYMENT! Each participant MUST complete the form. Please choose between Pipes and Drums or Honor Guard but not both. Name 4 Department Name Department City P Department State Cell Phone — -5—/ Email Address 194mul, P Please circle the appropriate response: What are you signing up for (Please Only Choose One) Honor Guard Honor Guard Commander Team Member Pipes Beginner Intermediate Advanced"" ""Advanced players will be required to audition for this group on day one Drums Snare error eginner Intermediate Advanced Will you require transportation from the airport Yes to� Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me if you wish to pay via credit card. I will call you to complete the registration. 2014 KTA Symposium [Registration The 2014 Registration fee for KTA is$65 per attendee. Checks can be made payable to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to use a credit card please include a daytime phone number and I will contact you to get the necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR PAYMENT! Each participant MUST complete the form. Please choose between Pipes and Drums or Honor Guard but not both. Name Department Name Department City ,e Department State H/ Cell Phone 7/' L-2-2 Email Address a n/ .o&- Please circle the appropriate response: What are you signing up for (Please Only Choose One) Honor Guard Honor Guard Commander Team Member Pipes Beginner Intermediate Advanced**** ****Advanced players will be required to audition for this group on day one Drums-� Tenor Bass Beginner fi ermediate Advanced Will you require transportation from the airport Yes _ Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me if you wish to pay via credit card. I will call you to complete the registration. 2® 14 KTA SymposoumRlegostration The 2014 Registration fee for KTA is$65 per attendee. Checks can be made payable to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to use a credit card please include a daytime phone number and I will contact you to get the necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR PAYMENT! Each participant MUST complete the form. Please choose between Pipes and Drums or Honor Guard but not both. Name /-�7c e Department Name G4R-Py Q L Department City Department State N Cell Phone 7 — / — Email Address `nJ . Please circle the agropriate response: What are you signing up for (Please Only Choose One) Honor Guard Honor Guard Commander Team Member Pipes Beginner Intermediate Advanced**** ****Advanced players will be required to audition for this group on day one ru na enor Bass Beginner < 11 n ermediate Advanced Will you require transportation from the airport Yes 0 Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me if you wish to pay via credit card. I will call you to complete the registration. 2014 KTA Symposium 'Registration The 2014 Registration fee for KTA is$65 per attendee. Checks can be made payable to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to use a credit card please include a daytime phone number and I will contact you to get the necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR PAYMENT! Each participant MUST complete the form. Please choose between Pipes and Drums or Honor Guard but not both. Name 2-eevel Department Name C4.k 2[ r. Department City e Department State Cell Phone — Email Address Please circle the appropriate response: What are you signing up for (Please Only Choose One) Honor Guard Honor Guard Commander Team Member " i e e i n r Intermediate Advanced**** ****Advanced players will be required to audition for this group on day one Drums Snare Tenor Bass Beginner Intermediate Advanced Will you require transportation from the airport Yes Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me if you wish to pay via credit card. I will call you to complete the registration. 2014 KTA Symposoum Rlegostratbn The 2014 Registration fee for KTA is$65 per attendee. Checks can be made payable to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to use a credit card please include a daytime phone number and I will contact you to get the necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR PAYMENT! Each participant MUST complete the form. Please choose between Pipes and Drums or Honor Guard but not both. Name As 4 Department Name Department City Department State Cell Phone -- Gtr Email Address eftP . t,V , Please circle the appropriate response: What are you signing up for (Please Only Choose One) Honor Guard Honor Guard Commander Team Member Pipes Beginner Intermediate Advanced**** ****Advanced players will be required to audition for this group on day one rum Tenor Bass Beginner ntermediat Advanced Will you require transportation from the airport Yes Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me if you wish to pay via credit card. I will call you to complete the registration. 2014 KTA Symposium Rlegistration The 2014 Registration fee for KTA is$65 per attendee. Checks can be made payable to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to use a credit card please include a daytime phone number and I will contact you to get the necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR PAYMENT! Each participant MUST complete the form. Please choose between Pipes and Drums or Honor Guard but not both. Name Department Nametj2r Department City ,,7e Department State Cell Phone C� c Email Address r Please circle the appropriate response: What are you signing up for (Please Only Choose One) Honor Guard Honor Guard Commander Team Member Pipes Beginner Intermediate Advanced**** ****Advanced players will be required to audition for this group on day one Drums Snare Tenor Bass Beginner Intermediate Advance Will you require transportation from the airport Yes No We are happy to provide transportation to and from DFW or Dallas Love Field. We will require your complete itinerary for arrival and departure flights. We also need a cell phone number that you will have with you while traveling to coordinate your transportation. Flight Information Arrival Airline Flight Number Arrival Date and Time Departure Airline Flight Number Departure Date and Time Mail completed registration and payment to: Lewisville Fire Department Attn: KTA Symposium PO Box 299002 Lewisville, TX 75029-3704 Print and Mail Completed Form To Address Below. You can fill this out scan and email it to me if you wish to pay via credit card. I will call you to complete the registration. 2014 KTA Symposoum Reg�stration The 2014 Registration fee for KTA is$65 per attendee. Checks can be made payable to City of Lewisville. If you wish to pay via credit card we can accommodate you. If you wish to use a credit card please include a daytime phone number and I will contact you to get the necessary information. YOU WILL NOT BE REGISTERED UNTIL WE RECEIVE YOUR PAYMENT! Each participant MUST complete the form. Please choose between Pipes and Drums or Honor Guard but not both. i Name c� . Department Name Department City Department State Cell Phone Email Address Please circle the appropriate response: What are you signing up for (Please Only Choose One) Honor Guard Honor Guard Commander Team Member Pipes Beginner Intermediate Advanced"" ""Advanced players will be required to audition for this group on day one D Snare enor ginner Intermediate Advanced Will you require transportation from the airport Yes No i i (Prescribed by State Board of Accounts City Form No.201(Rev 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) KTA Registrations $650.00 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Lewisville Fire Department KTA Symposium IN SUM OF $ PO Box 299002 Lewisville, TX 75029-3704 $650.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 I I 43-570.04 I $650.00 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except I� 9 4 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund