Participant Information

Name (preferred on name tag)

       Please note: Nametags will be required at all meetings and meals

Company/Organization

Address

City/State/Zip

Phone Fax

E-mail

Payment Information

Please choose one of the following:        (none selected) Pay with Credit Card Please send me an invoice   

Please mark all appropriate boxes: (for student or partial conference rates, you can view Partial Conference Rates, then print the Registration Form to send or fax in)

      $140 conference pre-registration fee (includes Pre-Conference fee, all materials, breaks, receptions, and luncheon) enclosed -
                    Deadline is January 22, 2010 (no longer available)

Late registration fee (after January 22) or at the door): $165 per person

Extra Wednesday evening banquet tickets available at $25 each (indicate number desired):

Total due $

We gladly accept VISA, MasterCard, and Discover

Select One:  (none) Visa Mastercard Discover

Name on card

                               (leave blank if you requested an invoice be sent to you)

We understand that circumstances arise that may require you to cancel. If you cancel your registration prior to five (5) business days before the meeting, your registration fee will be refunded, less $25 enrollment charge. If you cancel five (5) business days or less before the meeting, we cannot refund your registration fee, but you may send someone in your place.
You must notify our office immediately if you will have a substitute.