About the AUTM Western Region Meeting - Association of University ...
About the AUTM Western Region Meeting - Association of University ...
About the AUTM Western Region Meeting - Association of University ...
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<strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong><br />
Maximizing Value in Uncertain Times<br />
November 15 – 16, 2012<br />
The Meritage Resort and Spa, Napa, CA USA<br />
www.autm.net
2 <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> www.autm.net<br />
<strong>AUTM</strong> 2012 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong><br />
Maximizing Value in Uncertain Times<br />
<strong>AUTM</strong> 2012 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> Program Committee<br />
Vice President for <strong>Meeting</strong> Development<br />
Kevin Wozniak, Georgia Tech Research Corporation<br />
Assistant Vice President for <strong>Western</strong> <strong>Region</strong><br />
Joseph F. Janda, Portland State <strong>University</strong><br />
<strong>Meeting</strong> Chair<br />
Ian Bell, <strong>University</strong> <strong>of</strong> British Columbia<br />
Program Chair<br />
Rebecca Mahurin, Ph.D., Montana State <strong>University</strong><br />
Program Committee<br />
Lina Axanova, Salk Institute<br />
Nirdesh Gupta, Saban Research Institute <strong>of</strong> Children’s Hospital Los Angeles<br />
Seth D. Levy, J.D., Nixon Peabody LLP<br />
Robert MacWright, Ph.D., Esq., Salk Institute<br />
Dan Polonenko, Ph.D., Gowling Lafleur Henderson LLP<br />
William P. Ramey, III, Novak Druce + Quigg, LLP<br />
Manoja Ratnayake Lecamwasam, Ph.D., Catholic Healthcare West<br />
Andrew T. Serafini, Ph.D., Fenwick & West LLP<br />
<strong>About</strong> <strong>the</strong> <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong><br />
The <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> encourages interaction between colleagues<br />
from <strong>the</strong> western United States, <strong>the</strong> Asia-Pacific region and western Canada. The<br />
meeting will provide insights and networking opportunities for experienced and<br />
new technology transfer pr<strong>of</strong>essionals alike. The meeting <strong>of</strong>fers continuing legal<br />
education (CLE) credit for attorneys.<br />
Added Value<br />
Maximize your networking opportunities and plan to attend <strong>the</strong> <strong>AUTM</strong> Leadership<br />
Forum which takes place in <strong>the</strong> same location November 13-14, just prior to <strong>the</strong><br />
<strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong>. Save $200 by attending both meetings!<br />
<strong>About</strong> <strong>AUTM</strong><br />
The <strong>Association</strong> <strong>of</strong> <strong>University</strong> Technology<br />
Managers is a nonpr<strong>of</strong>it organization<br />
dedicated to promoting, supporting<br />
and enhancing <strong>the</strong> global academic<br />
technology transfer pr<strong>of</strong>ession through<br />
internal and external education, training<br />
and communications. <strong>AUTM</strong>’s more than<br />
3,000 members represent managers<br />
<strong>of</strong> intellectual property from more than<br />
300 universities, research institutions<br />
and teaching hospitals as well as<br />
numerous businesses and government<br />
organizations.<br />
<strong>Association</strong> <strong>of</strong> <strong>University</strong> Technology Managers ® , <strong>AUTM</strong> ® and<br />
registered trademarks <strong>of</strong> <strong>the</strong> <strong>Association</strong> <strong>of</strong> <strong>University</strong> Technology Managers.<br />
are
3 <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> www.autm.net<br />
<strong>AUTM</strong> Thanks 2012 <strong>Western</strong> <strong>Region</strong> Sponsors<br />
Gold Sponsor:<br />
Silver Sponsors:<br />
VALAUSKAS<br />
CORDER LLC<br />
Bronze Sponsors:<br />
Scholarship Provider:
4 <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> www.autm.net<br />
<strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> Is a Paperless <strong>Meeting</strong><br />
The <strong>AUTM</strong> 2012 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> will be paperless. Handouts will not be distributed at any educational session. All registrants<br />
will have online access to handouts before, during and after <strong>the</strong> meeting.<br />
Registered Technology Transfer Pr<strong>of</strong>essional (RTTP)<br />
Demonstrate your expertise in <strong>the</strong> academic technology transfer pr<strong>of</strong>ession by becoming a Registered Technology Transfer Pr<strong>of</strong>essional<br />
(RTTP). All <strong>AUTM</strong> pr<strong>of</strong>essional development courses and designated educational <strong>of</strong>ferings and meetings are eligible for continuing<br />
education (CE) credits, which support your registration application. For more information about <strong>the</strong> registration process and<br />
requirements, visit <strong>the</strong> Alliance <strong>of</strong> Technology Transfer Pr<strong>of</strong>essionals website at www.attp.info.<br />
Certified Licensing Pr<strong>of</strong>essionals (CLP) Continuing Education<br />
Certified Licensing Pr<strong>of</strong>essionals are required to demonstrate continued competence in <strong>the</strong>ir field to maintain <strong>the</strong>ir certification<br />
status. Individuals who hold <strong>the</strong> CLP designation can renew <strong>the</strong>ir credential by earning at least 40 continuing education (CE) credits.<br />
All <strong>AUTM</strong> pr<strong>of</strong>essional development courses and designated educational <strong>of</strong>ferings on <strong>the</strong> topics <strong>of</strong> licensing, technology transfer, and<br />
technology commercialization at <strong>AUTM</strong> conferences or meetings are eligible for CLP continuing education (CE) credits for certification<br />
renewal. Visit www.licensingcertification.org for more information on <strong>the</strong> recertification requirements.<br />
Continuing Legal Education Credit<br />
A total <strong>of</strong> 1.5 hours <strong>of</strong> Continuing Legal Education Credit (CLE) will be available for those who attend Legal Issues: Mayo v.<br />
Prome<strong>the</strong>us, Update on America Invents Act, and More.* CLE credit is available for California and New York. The meeting<br />
organizers will assist those licensed in o<strong>the</strong>r states to obtain CLE credit, if possible, where <strong>the</strong>y are licensed to practice.<br />
* Pending approval.
5 <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> www.autm.net<br />
<strong>Meeting</strong> Agenda<br />
Wednesday, November 14<br />
TBD<br />
Dessert Reception in conjunction with <strong>the</strong> <strong>AUTM</strong> Leadership Forum<br />
Thursday, November 15<br />
7:30 – 8:30 a.m. Continental Breakfast<br />
7:30 a.m. – 5 p.m. Registration<br />
8:30 – 10 a.m. Morphing Objectives and <strong>the</strong> Shape-changing Programs They Create<br />
Moderator: Lina Axanova, Salk Institute<br />
Speakers: Robert MacWright, Salk Institute<br />
Additional speakers TBA<br />
Varied institutional needs/priorities have led to a plethora <strong>of</strong> different technology transfer models. Forces that foster this diversity<br />
are not static; with <strong>the</strong> increasing pr<strong>of</strong>ile <strong>of</strong> technology transfer and current economic downturn, <strong>the</strong>se forces are being amplified by<br />
debate among state legislators, governors, Congress and even <strong>the</strong> White House. How do technology transfer directors change <strong>the</strong>ir<br />
programs over time to accommodate continuously morphing objectives? How do <strong>the</strong>y dynamically balance sometimes conflicting<br />
demands? How do <strong>the</strong>y decide which individuals or groups really set <strong>the</strong> agenda for <strong>the</strong>ir programs, and how do <strong>the</strong>y know when this<br />
has changed? A roundtable <strong>of</strong> experienced technology transfer directors will discuss <strong>the</strong>se questions and more, in an effort to reveal<br />
<strong>the</strong> dynamic state <strong>of</strong> technology transfer today, and <strong>of</strong>fer a glimpse <strong>of</strong> where it may be going tomorrow.<br />
10 – 10:30 a.m. Networking Break<br />
10:30 a.m. – Noon S<strong>of</strong>tware: Creation to Commercialization<br />
Moderator:<br />
Charles C. Valauskas, Valauskas Corder LLC<br />
S<strong>of</strong>tware is <strong>the</strong> basis for so many technologies. Managing it is <strong>of</strong>ten a challenge for technology transfer <strong>of</strong>fices. Join us to discuss<br />
<strong>the</strong> major issues that need to be addressed. Topics include: university ownership <strong>of</strong> student/faculty- created s<strong>of</strong>tware; whe<strong>the</strong>r/how<br />
s<strong>of</strong>tware-based technology can be patented in a post-Bilski world; licensing pitfalls (watch <strong>the</strong> grants clause!) and phone apps –<br />
issues in <strong>the</strong>ir development, protection and commercialization.<br />
Noon – 1:30 p.m.<br />
Networking Lunch<br />
1:30 – 3 p.m. Building Relationships for Effective Partnering – It’s <strong>About</strong> Values Not Just Valuation<br />
Moderator:<br />
Linda Kawano, GroupOptima<br />
Learn about <strong>the</strong> different cultural perspectives <strong>of</strong> academia and industry in an effort to build strong and sustainable business<br />
relations. Approaches for establishing trust will be identified and discussed.<br />
3 – 3:30 p.m. Networking Break
6 <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> www.autm.net<br />
<strong>Meeting</strong> Agenda<br />
Thursday, November 15 (continued)<br />
3:30 – 5 p.m. New Tools to Build Relationships<br />
Moderator: Rebecca Mahurin, Montana State <strong>University</strong><br />
Speakers: Karin Immergluck, <strong>University</strong> <strong>of</strong> California<br />
Kevin Wozniak, Georgia Tech Research Corporation<br />
Explore novel and creative relationships with industry, including <strong>the</strong> Pfizer/UCSF collaboration that creates an open network <strong>of</strong><br />
researchers to expedite translational research and Georgia Tech’s creative sponsored research approaches.<br />
6 – 7:30 p.m. Networking Reception<br />
Friday, November 16<br />
7:30 – 8:30 a.m. Continental Breakfast<br />
7:30 a.m. – 3 p.m. Registration<br />
8:30 – 10 a.m. Pro<strong>of</strong>-<strong>of</strong>-Concept Gap Funds: How to Achieve MORE with LESS<br />
Moderator:<br />
Nirdesh Gupta, Saban Research Institute <strong>of</strong> Children’s Hospital Los Angeles<br />
Speaker:<br />
TBA<br />
Examine models for pro<strong>of</strong>-<strong>of</strong> concept gap funds. Providing early stage investment capital to validate novel and innovative universitybased<br />
technologies adds value to technologies and provides a shorter path to licensability. You’ll gain insight into how funds are<br />
established and how to get buy-in from university leadership. We will also explore administering <strong>the</strong> funds and selecting technology<br />
candidates.<br />
10 – 10:30 a.m. Networking Break<br />
10:30 a.m. – Noon Legal Issues: Mayo v. Prome<strong>the</strong>us, Update on America Invents Act, and More<br />
Moderator:<br />
Seth D. Levy, Nixion Peabody LLP<br />
Speaker:<br />
TBA<br />
Review <strong>the</strong> U.S. Supreme Court’s decision in Mayo v Prome<strong>the</strong>us, addressing <strong>the</strong> fundamental issue <strong>of</strong> scope <strong>of</strong> patentable subject<br />
matter. Learn more about <strong>the</strong> implications <strong>of</strong> <strong>the</strong> case for technology transfer <strong>of</strong>fices. The panel will address patenting new<br />
technologies, managing existing patent portfolios and issues to consider in licensing negotiations. O<strong>the</strong>r important cases that may<br />
fur<strong>the</strong>r alter <strong>the</strong> legal landscape in this area will also be discussed, such as Assn. <strong>of</strong> Molecular Pathology v. Myriad Genetics. We will<br />
conclude with a brief update on <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> America Invents Act.<br />
Noon – 1:30 p.m.<br />
Networking Lunch
7 <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> www.autm.net<br />
<strong>Meeting</strong> Agenda<br />
Friday, November 16 (continued)<br />
1:30 – 3 p.m. Questions, Problems and Rants<br />
Speakers: Robert MacWright, Ph.D., Esq., Salk Institute<br />
Rebecca Mahurin, Ph.D., Montana State <strong>University</strong><br />
Every technology transfer <strong>of</strong>fice and every technology transfer pr<strong>of</strong>essional has <strong>the</strong>ir challenges; some unique, some that come with<br />
<strong>the</strong> territory. Wouldn’t you like to get some ad-hoc advice from your peers? Or maybe just rant? Here’s your big chance! We will<br />
collect your questions, problems, or proposed rants. The most common, provocative, and entertaining ones will be discussed in an<br />
open-forum format. For those who have submitted interesting rants, we will invite you to <strong>the</strong> microphone so you can express your<br />
outrage! We aim to make this session memorable, have it address both key issues and those that are rarely discussed, and give us all<br />
a chance to share our frustrations. We hope you will leave <strong>the</strong> session feeling that however daunting your challenges may be, at least<br />
you are not alone.<br />
3 p.m. <strong>Meeting</strong> Adjourns<br />
3 – 3:30 p.m. Planning Session for <strong>the</strong> <strong>AUTM</strong> 2013 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong><br />
Join us for this wrap-up session when <strong>the</strong> <strong>Western</strong> <strong>Region</strong> Program Committee leadership will <strong>of</strong>fer some final remarks about <strong>the</strong><br />
<strong>AUTM</strong> 2012 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong>, solicit volunteers and listen to your ideas for <strong>the</strong> <strong>AUTM</strong> 2013 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong>.
8 <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> www.autm.net<br />
General Information<br />
Hotel<br />
The Meritage Resort and Spa<br />
875 Bordeaux Way<br />
Napa, CA 94558<br />
Reservations: +1-866-370-NAPA (6272)<br />
Guest Phone: +1-707-251-1900<br />
Guest Fax: +1-707-254-8274<br />
www.<strong>the</strong>meritageresort.com<br />
<strong>AUTM</strong> has negotiated with The Meritage Resort and Spa a<br />
special rate <strong>of</strong> $189 per night for single or double occupancy.<br />
All rates are based on availability and subject to state and local<br />
taxes (which are currently 14 percent). A daily resort services<br />
fee <strong>of</strong> $20 per night will be accessed. To reserve a room at <strong>the</strong><br />
discounted rate, call The Meritage Resort and Spa reservations<br />
<strong>of</strong>fice at +1-866-370-6272 and identify yourself by <strong>the</strong> group<br />
name - <strong>Association</strong> <strong>of</strong> <strong>University</strong> Technology Managers (<strong>AUTM</strong>).<br />
If you prefer, make your reservations online. Be sure to make<br />
reservations by October 12, 2012; afterward, <strong>the</strong> discounted<br />
room rate may not apply. Guests can guarantee reservations<br />
with a major credit card. Make any necessary cancellations at<br />
least 72 hours (3 days) prior to arrival to avoid a one-night-fee<br />
cancellation charge.<br />
Location<br />
Situated at <strong>the</strong> sou<strong>the</strong>rn tip <strong>of</strong> Napa Valley, The Meritage is<br />
conveniently located close to wineries, downtown Napa and <strong>the</strong><br />
beautiful thoroughfares to wine country.<br />
Airport Transportation Information<br />
Oakland International Airport (OAK)<br />
The Meritage Resort and Spa is approximately a 60 minute drive<br />
from Oakland International Airport. Car service is available<br />
through The Meritage Resort and Spa’s concierge. Call +1-<br />
707-251-1916 for reservations at least 48 hours in advance.<br />
Rates start at $195 for up to four passengers each way. You<br />
may also contact Evans Transportation, <strong>the</strong> preferred shuttle<br />
service. Shuttles depart on a regular basis to and from <strong>the</strong><br />
airport for a flat rate <strong>of</strong> $45 each way, cash only. Reservations<br />
are not required for airport pick-up; however, <strong>the</strong>y are required<br />
for hotel pick-up. For additional information, reservations and<br />
<strong>the</strong> shuttle schedule visit: http://evanstransportation.com/<br />
rates_scheduled_airporter.php. Taxis are available outside <strong>of</strong><br />
baggage claim for approximately $165 one-way.<br />
San Francisco International Airport (SFO)<br />
The Meritage Resort and Spa is approximately a 75 minute<br />
drive from San Francisco International Airport. Car service is<br />
available through The Meritage Resort and Spa’s concierge.<br />
Call +1-707-251-1916 for reservations at least 48 hours<br />
in advance. Rates start at $195 for up to four passengers<br />
each way. You may also contact Evans Transportation, <strong>the</strong><br />
preferred shuttle service. Shuttles depart on a regular basis<br />
to and from <strong>the</strong> airport for a flat rate <strong>of</strong> $45 each way, cash<br />
only. Reservations are not required for airport pick-up;<br />
however, <strong>the</strong>y are required for hotel pick-up. For additional<br />
information, reservations and <strong>the</strong> shuttle schedule visit: http://<br />
evanstransportation.com/rates_scheduled_airporter.php. Taxis<br />
are available outside <strong>of</strong> baggage claim for approximately $165<br />
one-way.<br />
Sacramento International Airport (SMF)<br />
The Meritage Resort and Spa is approximately a 75 minute drive<br />
from Sacramento International Airport. Car service is available<br />
through The Meritage Resort and Spa’s concierge. Call +1-707-<br />
251-1916 for reservations at least 48 hours in advance. Rates<br />
start at $195 for up to four passengers each way. You may also<br />
contact Shuttle California, <strong>the</strong> preferred shuttle service. Shuttle<br />
fees are $90 per person, each way. Reservations are required<br />
and may be booked by visiting www.shuttlecalifornia.com. Taxis<br />
are available outside <strong>of</strong> baggage claim for approximately $165<br />
one-way.<br />
Car Rental<br />
Avis Rent A Car System Inc. is <strong>the</strong> <strong>of</strong>ficial car-rental service for<br />
<strong>the</strong> <strong>AUTM</strong> 2012 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong>. Reserve your car online<br />
or call +1-800-331-1600 and indicate Avis <strong>AUTM</strong> Worldwide<br />
Discount number J867535 to receive special pricing.<br />
Parking<br />
The Meritage Resort and Spa <strong>of</strong>fers complimentary self-parking<br />
and valet parking.<br />
International Visas<br />
Travelers coming from qualified countries to <strong>the</strong> United States<br />
for tourism or business for 90 days or less may be eligible to<br />
visit <strong>the</strong> United States without a visa. For additional information<br />
visit www.travel.state.gov/visa.
9 <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> www.autm.net<br />
General Information<br />
Attire and Wea<strong>the</strong>r<br />
Attire for <strong>the</strong> <strong>AUTM</strong> 2012 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> is business<br />
casual. The Napa average daytime high temperature in<br />
November is 65°F (18°C). The average low temperature is<br />
44°F (5.5°C). Because meeting room temperatures sometimes<br />
fluctuate, <strong>AUTM</strong> recommends bringing a light sweater or jacket.<br />
Registration<br />
<strong>AUTM</strong> will process meeting registrations only when <strong>the</strong>y are<br />
accompanied by a check or credit card information. Please<br />
note: registration forms, with fees paid, must be postmarked<br />
or received by fax by September 27, 2012 to qualify for <strong>the</strong><br />
discounted early rate. Registrations received after September<br />
27 will pay a higher rate. To be considered pre-registered,<br />
your registration, changes or substitutions must be received<br />
by October 25, 2012. After October 25, 2012, only onsite<br />
registrations will be accepted.<br />
Register for both <strong>the</strong> <strong>AUTM</strong> <strong>Western</strong> <strong>Region</strong><br />
<strong>Meeting</strong> and <strong>AUTM</strong> Leadership Forum<br />
for a Discount<br />
Directors, consider extending your trip and registering for <strong>the</strong><br />
<strong>AUTM</strong> Leadership Forum as well. Participants who register<br />
for both meetings are eligible for a $200 discount. To take<br />
advantage <strong>of</strong> this option, complete your <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong><br />
registration and check <strong>the</strong> box that says “I plan to register<br />
for <strong>the</strong> Leadership Forum as well.” An <strong>AUTM</strong> staff member<br />
will contact you within three business days to complete <strong>the</strong><br />
transaction.<br />
<strong>AUTM</strong> Membership<br />
Visit www.autm.net to view membership information or an<br />
online application.<br />
Questions<br />
If you have questions about <strong>the</strong> program or registration, contact<br />
Madhuri Carson at <strong>AUTM</strong> headquarters at mcarson@autm.net;<br />
+1-847-753-5217; or fax at +1-847-480-9282.
REGISTER TODAY!<br />
Only onsite registration will be<br />
allowed after Oct. 25<br />
Please Print<br />
Complete a separate form for each registrant.<br />
Given Name/First Name<br />
Surname/Family Name/Last Name<br />
❍ Do not post my name on <strong>the</strong> online pre-registration list.<br />
❍ Do not post my mobile number on <strong>the</strong> pre-registration list.<br />
❍ Update my member pr<strong>of</strong>ile with this information.<br />
Name for badge (if different than above)<br />
<strong>AUTM</strong> 2012 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> Registration Form<br />
Maximizing Value in Uncertain Times<br />
November 15 –16, 2012<br />
The Meritage Resort and Spa, Napa, CA USA<br />
Affiliation:<br />
❍ <strong>University</strong><br />
❍ Non-Pr<strong>of</strong>it Research Institute<br />
❍ Law Firm<br />
❍ Support Industry<br />
❍ Licensing Agent<br />
❍ Accountant<br />
❍ For-Pr<strong>of</strong>it Non-Academically Affiliated<br />
Research Firm<br />
❍ Teaching Hospital<br />
Register online at:<br />
www.autm.net/events<br />
It’s fast and secure.<br />
❍ Government Technology Transfer<br />
Program and/or Federal Lab<br />
❍ For-Pr<strong>of</strong>it Corporation<br />
❍ Technology Transfer Consultant<br />
❍ Venture Fund<br />
❍ Foundation<br />
❍ O<strong>the</strong>r, please list _____________________<br />
_______________________________________<br />
Job Title<br />
Organization<br />
Address<br />
City State/Province Zip/Postal Code<br />
Registration<br />
Preregistration policy: To be considered preregistered, your registration, with<br />
full payment, changes or replacement must be received by October 25, 2012.<br />
After this date, you must register onsite and pay <strong>the</strong> onsite registration fee. Faxed<br />
registration forms that do not contain credit card information do not qualify as an<br />
early registration.<br />
Payment Confirmation: Attendees will receive written confirmation from <strong>AUTM</strong><br />
headquarters. Because <strong>of</strong> registration and payment processing time, it may take<br />
up to two weeks for you to receive confirmation.<br />
Country<br />
Phone<br />
Email<br />
Fax<br />
Registration Cancellation Policy: Notification <strong>of</strong> cancellation must be submitted<br />
in writing. Cancellations received by October 25, 2012, will be subject to a $75<br />
cancellation charge. No refunds will be given after October 25, 2012. Substitutions<br />
are allowed at any time, but must be submitted in writing and must be <strong>of</strong> <strong>the</strong> same<br />
membership status.<br />
For U.S. citizens only: Contributions, gifts, dues or o<strong>the</strong>r payments to <strong>the</strong> <strong>Association</strong><br />
<strong>of</strong> <strong>University</strong> Technology Managers are not deductible for federal income tax<br />
purposes as charitable contributions. However, <strong>the</strong>y may be deductible as ordinary<br />
and necessary business expenses. Please consult your tax advisor.<br />
Emergency contact during meeting (Name, Telephone Number)<br />
Registration Fees All fees are quoted in U.S. dollars.<br />
Please check <strong>the</strong> appropriate fee:<br />
After<br />
Before After Oct. 25<br />
Sept. 27 Sept. 27 Onsite<br />
<strong>AUTM</strong> Member*: ❍ $425 ❍ $450 ❍ $475<br />
<strong>Meeting</strong> and Membership Package*: ❍ $710 ❍ $735 ❍ $760<br />
(includes a 2012 <strong>AUTM</strong> membership)<br />
Nonmember: ❍ $720 ❍ $745 ❍ $770<br />
* Membership in <strong>AUTM</strong> is on an individual basis and member fees apply only to <strong>the</strong><br />
individual who is a current member in good standing.<br />
Student: (Student ID required) ❍ $175 ❍ $175 ❍ $175<br />
Accompanying Person: ❍ $150 ❍ $150 ❍ $150<br />
(Admission to group meals and receptions only)<br />
Name <strong>of</strong> Accompanying Person: _____________________________________<br />
Name<br />
❍ I plan to register for <strong>the</strong> 2012 Leadership Forum and qualify for a $200 discount.<br />
If you select <strong>the</strong> option above, an <strong>AUTM</strong> staff member will contact you within 3<br />
business days to complete your registration for <strong>the</strong> Leadership Forum and will apply<br />
your discount <strong>of</strong> $200.<br />
Register online at www.autm.net<br />
www.autm.net<br />
Complete this registration form and mail it with<br />
<strong>the</strong> appropriate fees to:<br />
<strong>Association</strong> <strong>of</strong> <strong>University</strong> Technology Managers<br />
33661 Treasury Center<br />
Chicago, IL 60694-3600<br />
Or fax to <strong>AUTM</strong> with credit card payment information to:<br />
+1-847-480-9282<br />
Payment (<strong>AUTM</strong> Taxpayer ID# 36-3011951)<br />
❍ Check<br />
Check enclosed for $ ____________________________<br />
Please make check payable to:<br />
<strong>Association</strong> <strong>of</strong> <strong>University</strong> Technology Managers Inc.<br />
Funds must be in U.S. dollars.<br />
Credit Card<br />
❍ VISA ❍ MasterCard ❍ American Express ❍ Discover<br />
❍ Wire Transfer (please include applicable wire transfer fees)<br />
Amount $ _______________________<br />
Print name as it appears on card<br />
Card Number<br />
Signature<br />
Credit Card Billing Address (if different than above)<br />
CAUTION: If you submit your registration form more than once, it may result in a duplicate charge on your credit card.<br />
Please send your registration using only one method <strong>of</strong> payment and submission.<br />
Exp. Date(mm/yy)<br />
City State Zip/Postal Code<br />
Special Needs<br />
Please contact <strong>AUTM</strong> Headquarters at +1-847-559-0846;<br />
Fax +1-847-480-9282; email mcarson@autm.net if you have any<br />
special needs.<br />
* The <strong>Meeting</strong> and Membership Package includes admission to <strong>the</strong> 2012 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong><br />
and a 2012 <strong>AUTM</strong> membership, which will expire December 31, 2012.<br />
This package is not available for student memberships.<br />
<strong>AUTM</strong> 2012 <strong>Western</strong> <strong>Region</strong> <strong>Meeting</strong> – Maximizing Value in Uncertain Times
Save <strong>the</strong> Date<br />
Annual <strong>Meeting</strong>s<br />
2013<br />
February 27 – March 2<br />
Henry B. Gonzalez Convention Center & San<br />
Antonio Marriott Rivercenter/Riverwalk<br />
San Antonio, TX USA<br />
2014<br />
February 19 – 22<br />
San Francisco Marriott Marquis<br />
San Francisco, CA USA<br />
2016<br />
February 14 – 17<br />
Manchester Grand Hyatt San Diego<br />
San Diego, CA USA<br />
2017<br />
March 12 – 15<br />
The Westin Diplomat Resort & Spa<br />
Hollywood, FL USA<br />
2015<br />
February 22 – 25<br />
Hyatt Regency New Orleans<br />
New Orleans, LA USA