REGISTRATION FORM 2013 IKECA Annual Membership Meeting ...
REGISTRATION FORM 2013 IKECA Annual Membership Meeting ...
REGISTRATION FORM 2013 IKECA Annual Membership Meeting ...
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Three Easy Ways to Register:Mail or Fax, or Online to open soon!<strong>REGISTRATION</strong> <strong>FORM</strong><strong>2013</strong> <strong>IKECA</strong> <strong>Annual</strong> <strong>Membership</strong> <strong>Meeting</strong>April 17-20, <strong>2013</strong>| Naples, FLHilton NaplesCONTACT IN<strong>FORM</strong>ATION (Please print your name and company exactly how you would like it published.)Name (Attendee 1):Company Name:Address:Nickname (for Badge):Companion Name:City: State/Province: Zip:Telephone:Special Needs/Dietary Requirements:Email (REQUIRED):Emergency Contact (Name/Phone): Check here if this is your organization’s first <strong>IKECA</strong> <strong>Annual</strong> <strong>Meeting</strong>ADDITIONAL ATTENDEES (Add additional attendees and reception/spouse/companions on the following page):Name (Attendee 2):Attendee Email:Name (Attendee 3):Nickname (for Badge):Emergency (Name/Phone):Nickname (for Badge):Attendee Email:Emergency (Name/Phone):CECS, CESI and CECT exams require SEPARATE applications and fees. Check here if you would like to register for an exam and download the exam application here.Early Bird Rates (Available Until March 27, <strong>2013</strong>) Regular Rates (After March 27, <strong>2013</strong>)Quantity Attendee Type Fee Total Quantity Attendee Type Fee TotalFirst Attendee $575 First Attendee $675AdditionalAttendeeFirst AttendeeNon-MemberSpouse/companion(full access)Friday Only – Tech& Code ReviewReception Only-GuestDine AroundDinners Wed-Fri$475$800$300$100$50*IndividualPayAdditionalAttendeeAttendeeNon-MemberSpouse/companion(full access)Friday Only – Tech& Code ReviewReception Only-GusetDine AroundDinners Wed-Fri$575$875$300$100$50*IndividualPaySunset Cruise $40** Sunset Cruise $40**Payment: All registrations must be prepaid. Please make checks payable to <strong>IKECA</strong> in US Dollars.Total Registration Amount: $:_____________________Payment Type Check #:____________ Visa MasterCard American ExpressCredit Card #: Exp. Date CVV #:Cardholder Name:Signature:
Three Easy Ways to Register:Mail or Fax, or Online to open soon!<strong>REGISTRATION</strong> <strong>FORM</strong><strong>2013</strong> <strong>IKECA</strong> <strong>Annual</strong> <strong>Membership</strong> <strong>Meeting</strong>April 17-20, <strong>2013</strong>| Naples, FLHilton NaplesName (Attendee 4):Attendee Email:Name (Attendee 5):Attendee Email:Name (Attendee 6):Attendee Email:Reception Only - Name (Attendee 1):Nickname (for Badge):Emergency (Name/Phone):Nickname (for Badge):Emergency (Name/Phone):Nickname (for Badge):Emergency (Name/Phone):Nickname (for Badge):Attendee Email:Reception Only - Name (Attendee 2):Nickname (for Badge):Attendee Email:Spouse/Companion - Name (Attendee 1):Nickname (for Badge):Attendee Email:Spouse/Companion - Name (Attendee 1):Nickname (for Badge):Attendee Email:Additional InformationFriday Networking Reception*Please note that the Friday evening reception is included in the regular registration fee. There is an option forattendees to bring a guest to the reception for a fee of $50, allowing access to Friday’s reception only.CancellationsCancellations must be received in writing by April 5, <strong>2013</strong> to receive a refund and are subject to a $100processing fee. Forms must be received by April 5, <strong>2013</strong> or you will have the option to register onsite. Thereare no refunds issued for Cruise Tour on Saturday, April 20 th .**Please note that registration for the Sunset Cruise is non-refundable if <strong>IKECA</strong> obtains the minimum numberrequired. If the cruise does not take place, a full refund for the cruise will be provided within 90 days of the<strong>Meeting</strong>s’ conclusion.Dine Around DinnersThis is a great networking opportunity, especially if you are new to <strong>IKECA</strong>! Reservations will be made atvarious restaurants in downtown Naples. Attendees are responsible for all fees associated with transportationand food and beverage. If you would like to participate, please note this on the registration form above.Registrations will be available on a first come, first-served basis. A member of the <strong>IKECA</strong> Management Teamwill contact you with available restaurant selections.Spouse/Companion RegistrationSpouses/companions who register at the full access rate are eligible to attend all events throughout the courseof the Seminar. Spouses/companions who wish to attend just the Thursday evening reception may register forthat event separately.100 N. 20 th Street, Suite 400, Philadelphia, PA 19103 P: (215) 320-4982 F: (215) 564-2175 E: information@ikeca.org
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