IES Registration Form

Revised: May 09, 2008

This form allows for on-line registration. For those uncomfortable with provision of credit card information (e.g., number and expiration date), please omit credit card data (except credit card type) and submit all other information on this form by pressing the Submit Form button. Send credit card information separately by Fax (+1-703-360-3954). Fax is in secure location. 

Please provide the following contact information:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
URL

Please provide the following ordering information:

QTY DESCRIPTION & COST
Full Registration for Early Birds ($425.00) (before 01 April 2008)
Full Registration ($475.00) (after 01 April 2008)
Full Registration (Students & Retirees) ($150.00)
1-Day Registration: ($200.00) (Before April 01)
1-Day Registration: ($250.00) (After April 01)
2-Day Registration: ($300.00) (Before April 01)
2-Day Registration: ($350.00) (After April 01)
Extra Awards Luncheon Ticket ($25.00) (on 5-14-08)
Extra Pre-Print Document ($50.00) + applicable Tax

 

Note_1: Residents of Virginia will be charged 4.5% sales tax for extra Pre-Print document ($2.25)

Note_2: Student, Retiree, 1-Day, and 2-Day  registrants may register at any time with no change in fee (i.e., no late fees). An Awards Luncheon ticket is included in the registration fee for "Full Registrants" and  for "Students & Retirees".

Note_3: 1-Day and 2-Day Registrants will be assessed an additional $25.00 to attend the luncheon on Wednesday May 14th (2nd day of conference).

Note_4: Excess Page charges for authors only. ($50.00/page in excess of 8 pages.)

$ Excess page charge (authors) total

Please total the fees above to determine the amount required. This is done by summing the cost for each ordered item. Enter the Grand Total in the box provided below: 

$ Grand Total

Registrants may pay by check or credit card. VISA, American Express, and Mastercard are accepted. Checks should be made out to IES-JMG Associates and mailed to IES, c/o JMG Associates Ltd., 8310 Lilac Lane, Alexandria VA 22308-1943. 

CREDIT CARD BILLING

Credit Card
Cardholder Name

Card_Number/Expiration_Date (Note that this is free form, so just be sure the credit card number & date both appear in the box somewhere. The order is unimportant. The form is read manually.)

 

jmgood@starpower.net and jm_good@cox.net
Copyright © 2001-2007,  All rights reserved.
Revised: April 16, 2008