NAPEO Annual Conference 2006
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Program at a Glance

Registration Form

    REGISTRANT INFORMATION
    Please register one person at a time on this form.

      First Name*
      MI
      Last Name*
      Designation
      Nickname for badge*
      (if different than first name)
      Company*
      Address 1*
      Address 2
      City*
      State*
      Zip*
      Phone*
      Fax
      E-mail*
      Emergency Contact:
      Phone:
      * Required fields
    REGISTRATION

    Full conference registration includes all educational sessions, exhibits, continental breakfasts, lunches, roundtables, and networking receptions.

      Member Non-Member Subtotal
    Full Conference Registration
    1st Registration from Company $820 $1,745 $
    Additional Registrations from Company $770 $1,695
     
      Member Non-Member None Subtotal
    One-Day Registration
    Monday, September 11 $300 $600 $0 $
    Tuesday, September 12 $400 $750 $0
    Wednesday, September 13 $300 $600 $0
     
    Exhibit Hall Only Passes – Not for exhibitors, for admittance into the exhibit hall only, no admittance into the general or concurrent sessions.
    Monday (9-11) Opening Reception, 5:30pm – 7:30pm $35 $
    Tuesday (9-12) Lunch, 11:30am – 1:30pm $35
    Tuesday (9-12) Reception, 5:00pm – 7:00pm $35
    Wednesday (9-13) Breakfast, 8:30am – 9:45am $35
     

    HAVANA NIGHT PARTY
    SOLD OUT
     

    SPECIAL NEEDS
    NAPEO wants all attendees to fully benefit from all aspects of the conference. Please check the box below if you have a disability and indicate any special assistance required. Please also indicate if you have special dietary needs.

    Special Requirement(s), Describe:
     

    PAYMENT INFORMATION
    All registrations must be pre-paid prior to start of conference.

    Check payment will be mailed, payable to NAPEO for $

    Please bill my: VISA     MC      American Express
    Amount Authorized: $
    Credit Card #
    Security code* (*4 digits on front of Amex; 3 digits on back of MC/Visa)
    Expiration Date /
    Name on card First:  Last:
    Billing Address Same as above
     
     

    CANCELLATION POLICY
    Refunds requested on or before September 1, 2006, must be submitted in writing to NAPEO headquarters. A $50 processing fee per registration will be assessed. Replacements may be made in lieu of cancellations for $25 per replacement. No refunds will be given after September 1, 2006.

    I have read and agree to NAPEO's cancellation policy*.

    QUESTIONS
    Call 703-836-0466.