NAFSA: Association of International Educators

Transcription

1 NAFSA: Association of International Educators Region I Conference: The Art of International Education Tacoma, WA, November 7 10, 2012 Registration Form NAME (Surname): (First Name): Name (no titles, please) as you wish it to appear on nametag: INSTITUTION: (As you wish it to appear on nametag): MAILING ADDRESS: TELEPHONE: Mobile: FAX: Tell about yourself: Are you a member of NAFSA? Yes (NAFSA MEMBERSHIP #: required) (If you do not know your membership #, please contact NAFSA at ext. 0) No Not a current member but am joining now at half-price See separate membership application for half-price NAFSA memberships. Is this your first NAFSA conference? Yes No Is this your first regional conference? Yes No Are you the guest /spouse of an attendee? Yes No Are you a community member or student? Yes No NAFSA Knowledge Communities (Please check all that are appropriate. Visit NAFSA s website for more details: Education Abroad International Education Leadership International Enrollment Management (Note: ESL Instruction & Administration is included in this KC) International Student & Scholar Services Teaching, Learning and Scholarship Diversity Data: NAFSA is committed to increasing the diversity of members participating in this conference. We ask U.S. citizens or permanent residents to voluntarily self-identify by checking the box next to one of the ethnicities below. If you are not a U.S. citizen or permanent resident, please check foreign. The data are used only in the aggregate. A: African American / Black B: American Indian/Native American C: Asian American/Pacific Islander D: Caucasian/White E: Hispanic/Latino/Chicano F: Multicultural G: Other ethnicity: H: Foreign Dietary Restrictions I request vegetarian meals Yes No I request gluten-free meals Yes No (Note: A request for vegetarian or gluten-free meals cannot be changed at the time of the conference. Participants who DO NOT make these selections will not have the option of requesting them at the conference. Special meal selections may not be available to attendees who register on-site)

2 A. SPECIAL EVENTS Please indicate which conference events you will attend. All but the Glass Blowing Workshop are included in the conference registration fee, but by indicating your attendance you will help us plan for the events. Fees for Glass Blowing will be collected at the conference Event Date Time Attending Cost Welcome the Artists Reception Nov. 8 th 5:45 6:45 PM Attending Attendee: $0 Number of Guests: Guest: $20 Awards Luncheon Nov. 9 th 12:00 2:00 PM Attending Attendee: $0 Number of Guests: Guest: $35 Gala Auction Nov. 9 th 7:00 10:00 PM Attending Attendee: $0 Number of Guests: Guest: $30 Glass Blowing Workshop Nov. 10 th 1:30 5:00 PM Attending Total number: Attendee: $60 B. PRE CONFERENCE WORKSHOPS Check the workshop(s) you are planning to attend. If you register for more than one workshop, please make sure that they do not conflict. Enrollment in each workshop is limited, so pre-registration is required. You will receive confirmation by , fax, or mail. Workshop fees are not included in the general conference registration fee. If you are attending a workshop and are not staying for the conference, you do not have to pay the conference registration fee. Workshop Fees through Oct. 5, 2012 Fees after Oct. 5, 2012 F-1 Student Advising for Beginners Date: November 7 th ; 8:00-6:00 PM F-1 Student Advising: Intermediate Date: November 7 th ; 8:00 5:00 PM Foreign Educational Credentials Analysis Date: November 7 th, 8:00-4:00 PM AND November 8 th, 8:00 11:00 AM Basic Immigration Concepts for Professionals Outside of International Student Advising Date: November 7 th, 1:00 5:00 PM The Art of Strategic Programming & Event Management in International Education Date: November 8 th, 8:00 12:00 PM F-1 Employment Date: November 8 th, 8:00 12:00 PM Member: $200 Non-Member: $345 Member: $225 Non-Member: $365 Sub-Total Fees for Special Events and Workshops (A-B) 2

3 C. REGISTRATION FEES Early-Registration Fees (through Oct. 5, 2012) The full conference registration fees include all sessions, All Conference Luncheon, Welcome Reception, Auction Gala, two continental breakfasts, and refreshment breaks Deadline for postmarked forms to receive the pre-registration rates is Oct. 5, Please check the appropriate fees. Eligible for discounted rate: any attendee who is staying at the conference hotel an attendee who is not staying at the conference hotel but who lives within 50 miles of the conference hotel. Proximity to home address must be documented using Google Maps to qualify for the discounted rate. Staying at Conference Hotel (discounted rate) $220 NAFSA Member $260 Non-member $150 Community member, Student, Retiree I live within 50 miles of the conference hotel. My Google Maps documentation is attached. Not Staying at Conference Hotel (full rate) $320 NAFSA Member* $360 Non-Member $250 Community member, Student, Retiree Single Day $160 Single Day Member * $220 Single Day Non-Member * Please check one: Thursday Friday Saturday * Rate Available to those attending one day only. Registration Fees (after Oct. 5, 2012) The full conference registration fees include all sessions, All Conference Luncheon, Welcome Reception, Auction Gala,, and refreshment breaks. Due to conference volume and hotel catering deadlines, we may not be able to accommodate onsite registrants at all-attendee mealsplease check the appropriate fees. Eligible for discounted rate: any attendee who is staying at the conference hotel an attendee who is not staying at the conference hotel but who lives within 50 miles of the conference hotel. Proximity to home address must be documented using Google Maps to qualify for the discounted rate. Staying at Conference Hotel (discounted rate) $270 NAFSA Member $310 Non-member staying in conference hotel $150 Community member, Student, Retiree I live within 50 miles of the conference hotel. My Google Maps documentation is attached. Not Staying at Conference Hotel (full rate) $370 NAFSA Member* $410 Non-Member $250 Community member, Student, Retiree Single Day $210 Single Day Member * $270 Single Day Non-Member * Please check one: Thursday Friday Saturday * Rate Available to those attending one day only. 3

4 D. Special Services / Emergency Contact Information SPECIAL SERVICES REQUIRED: Persons with disabilities must indicate special services needed below and submit by October 5, 2012 Emergency Contact Information In the event of an emergency, please contact: Name: _ Telephone: Relationship to registrant: E. PAYMENTS TOTAL FEES: Special Event & Workshop Fees (A-B) Registration Fees (C) Total Fees to Region Checks payable to NAFSA Region I All conference fees should be submitted with this form. Checks must include the names of all registrants. Cash $ Institutional Check # $ Personal Check # $ Credit Card: Visa Master Card American Express Card # Expiration Name on Card Signature 4

5 Refunds: Conference registration and/or workshop registration may be canceled with full refund, if the Conference Cochair(s) or Conference Registar(s) receives a written request for cancellation and refund by Friday, October 5, 2012 Midnight PST. Requests for cancellation and refunds received after the deadline may be approved by the Conference Co-chairs at his/her discretion. Fees for special events are non-refundable. If you are not able to register online, please mail this form to: Attention: Mark Goldfarb NAFSA Registration Bureau, 411 Lafayette Street, Suite 201, New York, NY OR Fax to: For questions about registration call or mgoldfarb@pcm411.com 5