15th Conference Registration Form Brochure

ATTENDEE PRE-REGISTRATION FORM SUBMIT BY 6/20/11 FOR DISCOUNTED RATES FAXED FORMS DUE BY: 7/8/11 REFUNDS GIVEN BEFORE 7/22/11 14TH CONFERENCE ON MESOSCALE PROCESSES AND 15TH CONFERENCE ON AVIATION, RANGE, AND AEROSPACE METEOROLOGY 1-4 AUGUST, 2011 LOS ANGELES AIRPORT MARRIOTT LOS ANGELES, CA NAME: ___________________________________ WORK TEL #: NAME: AFFILIATION: WORK ADDRESS: FAX #: IN CASE OF EMERGENCY, CONTACT Name and #: E-MAIL: AFFILIATION TYPE: (See Box 1 on reverse) DO YOU WANT YOUR NAME PUBLISHED ON THE ATTENDANCE LIST? (See reverse) ? YES ? NOGUEST/HOTEL INFORMATION (FOR AMS INFORMATION ONLY; ATTENDEE IS RESPONSIBLE FOR MAKING OWN HOTEL RESERVATION) ARE YOU BRINGING A GUEST? ? YES ? NO If yes, NAME OF YOUR GUEST (FOR BADGE): HOTEL NAME ARRIVAL DATE: DEPARTURE DATE: ? SINGLE or ? DOUBLE REGISTRATION PACKAGES (SEE BOX 2 ON PAGE 2) 1) PACKAGE CHOICE: (SEE BOX 2 ON PAGE 2) 2) ATTENDEE TYPE: (SEE BOX 3 ON REVERSE) ? Full-Week ? One-Day If One-Day Package, Indicate DAY OF WEEK: TOTAL CONFERENCE FEES AND METHOD OF PAYMENT ? CHECK ? PURCHASE ORDER #: REGISTRATION FEE: $ . ? CREDIT CARD (? MasterCard ? VISA ? AMEX) TOTAL CONFERENCE FEES $______________________ Card # ____________________________________________ Expiration Date: ________________________ Name on Credit Card: Street Address as it appears on Credit Card Statement: City: ________________________________ State/Prov.______________ Zip/Postal Code: _________ MAIL TO: AMS 14MESO/15ARAM, 45 Beacon St., Boston, MA 02108 Fax: (617) 249-0272 REGISTRATION POLICY Submit this form with payment by June 20, 2011 in order to receive the lower registration rate. Registrations received at AMS from 05/7/10 and through the conference dates will be processed at the higher rate (SEE RATES BELOW). After July 8, 2011 please register at On-line. After July 18, please register at the meeting. Payment may be made with check, purchase order (HARD COPY REQUIRED) or credit card (MASTERCARD/VISA/ AMERICAN EXPRESS). FAXED registration forms must be accompanied by payment (PO OR CREDIT CARD # ONLY). Refunds are given (LESS A $25 FEE) if cancellation is received July 22, 2011 (NO REFUNDS THEREAFTER). Registration will not be processed without payment. Confirmation of registration will be e-mailed. ATTENDANCE LISTS The AMS will be making the attendance list from this meeting available to attendees and exhibitors (if participating). The list will be provided in electronic form only and will include attendee name, affiliation (if provided), address, city, state, zip code, and country. No phone, facsimile, or e-mail address will be provided on the list. To request a copy of this list, inquire at the AMS Registration Desk on-site. BOX 1: SELECT ONE OF THE FOLLOWING AFFILIATION TYPES AND FILL IN ON THE REVERSE: • GOVERNMENT • PRIVATE SECTOR • STUDENT • UNIVERSITY BOX 2: SELECT REGISTRATION PACKAGE AND YOUR ATTENDEE TYPE AND FILL IN ON THE REVERSE FULL-WEEK PACKAGE includes: admission to all sessions, coffee breaks, poster viewings, and Lunches (Mon-Thurs). The One-Day package includes admission to all of the above for one calendar day. ONE-DAY PACKAGE: includes: admission to all sessions, coffee breaks, poster viewings, and for one calendar day. ATTENDEE TYPE By 20 June After 20 June By 20 June After 20 June AMS FULL MEMBER;; PROGRAM CHAIR & SESSION CHAIR $585 $625 $295 $335 AMS ASSOC. MEMBER, NONMEMBER SPEAKER/POSTER PRESENTER* $625 $665 $295 $335 NON-MEMBER $670 $710 $295 $335 RETIRED MEMBER $335 $375 $130 $170 AMS STUDENT MEMBER $310 $350 $100 $140 STUDENT NON-MEMBER $340 $380 $130 $170