Toronto Conference Registration Form

2nd NorthAmericanConferenceon Ozone,Ultraviolet & AdvancedOxidationTechnologiesCo-organized byIOA and IUVAFairmont Royal York HotelToronto, Ontario, CanadaSeptember 18 - 21, 2011For further information, please visit: www.io3a.orgInternationalOzone AssociationInternationalUltraviolet Association Toronto, Ontario, Canada Fairmont Royal York September 18-21, 2011 PARTICIPANT INFORMATION Last Name: ______________________________________ First Name: __________________________ Organization: _________________________________________ Position: ________________________ Address: ________________________________ ____________________ __________ ___________ ___________ Street City State/Province Postal Code Country Phone: __________________________ Fax: __________________________ E-mail: __________________________ Name of Accompanying Person(s): _________________ E-mail of Accompanying Person(s): ________________________ Name of Accompanying Person(s): _________________ E-mail of Accompanying Person(s): ________________________ REGISTRATION FEES Before June 30, 2011 Before August 31, 2011 After August 31 & On-Site Payment IOA and/or IUVA membership* (Discounted rates at conferences and subscription(s) to the publication of your selected association(s).) See www.io3a.org and/or www.iuva.org See website(s) for membership fees Type of membership____________________ ________ Member - Full Registration - Add $150 for Non-member (Includes Technical sessions, Sun/Mon receptions, 2 lunches & banquet) $550 $650 $750 ________ Member - Student Full Registration - Valid Student ID required. (Incl. Tech. sessions, Sun/Mon receptions & 2 lunches) - Add $75 Non-member $225 $250 $275 ________ Member - One Day Registration, Monday __ Tuesday __ (Includes Tech. sessions, exhibits and 1 lunch) - Add $75 for Non-Member $250 $300 $350 ________ Exhibits Only, Monday __ Tuesday __ $25/day $25/day $30/day ________ Ozone Operations Workshop – More Information $125 $135 $150 ________ UV Operations Workshop – More Information $125 $135 $150 ________ Technical Tours: Ozone Information UV Information $50 $60 $75 ________ Sunday UV Workshop More Information $150 $160 $175 ________ Sunday Ozone Workshop More Information $150 $160 $175 ________ Accompanying person registration, with Full Registration (Includes Sun/Mon receptions, exhibits & banquet. Lunches not included. Attendees that wish to attend Tech. sessions must purchase a full registration.) $175 $200 $225 ________ Sunday Opening Reception Tickets Quantity: ______ $55 $65 $75 ________ Monday Exhibitor Reception Tickets Quantity: ______ $55 $65 $75 ________ Tuesday Banquet Reception Tickets Quantity: ______ $80 $90 $95 ________ Lunches, Quantity and Day: M __ T __ $50 $60 $70 ________ *Special Conference Offer Join BOTH associations as an individual member (EI) for $200 **Optional Programs, not included in a Full Registration Total __________ METHOD OF REGISTRATION PAYMENT Registration forms MUST be accompanied with payment to be processed. Personal Check Company Check Make checks payable to IOA in U.S. Funds American Express MasterCard Visa Discover Billing Address______________________________________________________________________________________________ Credit Card No. ________________________________________ Expiration Date ______________ Signature______________________________________________ Cancellation policy: Full refunds will be provided if notified by June 30, 2011; a 50 percent refund will be provided if notified by August 31, 2011; and no refund will be provided after August 31, 2011. Dr. Ms. Mr. ____ Mrs. North American Joint Regional Conference ATTENDEE REGISTRATIONRegister for the conference online or complete this registration form and fax/mail with full payment or credit card information to: IOA – IUVA 2011 PO Box 28873, Scottsdale, AZ 85255 Fax: 480-473-9068 Questions? www.iuva.org or www.io3a.org +1 480-544-0105