"Linking to the Future" - Conference Registration
HeSCA/ABCD Annual Meeting June 28- July 1, 2000
Please print this form and mail or fax to the address/number below.
Name____________________________Title__________________________________
Department____________________________________________________________
Institution/Business_______________________________________________________
Address_______________________________________________________________
City________________________ State_______Zip_________Country______________
Phone____________Fax_____________E-mail____________________________
Emergency contact Name_________________Emergency contact phone_____________
This is my first HeSCA/ABCD meeting.
I
am a member of (check all that apply):
ABCD
AMI
BCA
HeSCA
IMI
Registration Categories (Register before May 26 to save $100!)
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Preregistration (before May 26) |
Registration (after May 26) |
One Day Only |
On-Site One Day Only |
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Member |
$395 |
$495 |
$195 |
$295 |
|
Nonmember |
$495 |
$595 |
$240 |
$340 |
|
Student/Retired |
$295 |
$395 |
$150 |
$250 |
Select Workshops $80 before May 26 / $100 after May 26
*Full day on 6/30 - ABCD Members only |
Select Special Event(s)
List top 3 topic numbers _______________
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Select Banquet Menu Choice ( included in registration)
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Additional Banquet Tickets - $50 each
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Add It Up
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Payment method Payment can be made by credit card or by check or by money order (U.S. Funds) made payable to HeSCA. Nonmembers: Join now and save!
Card No.________________ Exp. Date______ Name on card__________________________ Signature______________________________ |
Send or Fax Registration and Payment:
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HeSCA 2000 Annual Meeting c/o Eastern Business Service One Wedgewood Drive, Suite 28 Jewett City, CT 06351-2428 |
Fax: (860) 376-6621 Phone: (860) 376-5915 |
Special needs:HeSCA and ABCD are committed to compliance with the Americans with Disabilities Act (ADA). Participants who require assistance must notify HeSCA in advance of the meeting. Every reasonable effort will be made to accommodate meeting needs. Hotel facility needs are the responsibility of Sunspree. Refunds:Preregistration must be received by May 26, 2000. Refunds will be given prior to May 26, 2000, minus a $35 administrative fee. No refunds will be made after June 2, 2000.