TAS 2012 ANNUAL MEETING REGISTRATION FORM

ONLINE REGISTRATION CLOSED

Any New Online Registrations Submitted Will not be Recorded

Late Registration will be available on-site

 Each person MUST register individually. When registering each person must open a new browser window and not reuse the same cleared form. Register early. Late fees will be in effect after 5pm 2/15/2012.

 

Please complete the registration form below. You must be a member to register. If you need to pay your membership dues then select the appropriate membership classification.   Please click the Submit button at the bottom of the page after completing the registration form to proceed to the online registration payment page.

 

*First Name:
*Last:
*Name Tag:
*Address Line 1:
Address Line 2:
*City:
*State:
*Zip:
Country:
*University/Business:
Department:
*Phone:
*Email:

 

Late Registration and Refund Information

Late registration begins after 5pm February 15, 2012.  Late registration fees are in parentheses and will be charged at checkout.  Late registration does not guarantee a banquet meal for the  registrant.

Registration refunds minus a $10 handling fee will be available until February 22, 2012 if requested by email.  Requests for refunds must be emailed by 5pm February 22.  Send the refund request to Andy Kasner kasnera@wbu.edu.

 
*Please select a registration fee category:
Professional (non-student) - $170 (Late $185)
Student - $60 (Late $75)
Student Type:

 

 
If you need to pay membership dues, please select a membership category:
Undergraduate Student Membership - $15
Graduate Student Membership - $15
Senior Academy Regular Membership - $30
Supporting Member - $60 (Regular plus donation)
Sustaining Member - $100 (Regular plus donation)
Patron Member - $150 (Regular plus donation)
Corporate Member - $150
Emeritus Member (Retired member) - $10
Joint Membership - $35
High School - $30
Institutional - $50
Purchase a Printed Program:
$5 - Yes


Please enter the number of T-Shirts you want in each size ($20 each)
Small:
Medium:
Large:
XL:
XXL:

 

 
# of Guests (not counting yourself) - $50/guest :
Guest Name Tags:


 

Head Count for Meals - indicate below the number attending each event (including yourself and guests).
*Thursday Night Reception:
*Friday Lunch:
*Social hour before Friday Banquet:
*Friday Evening Banquet - Required to receive Student Awards:
Do you require vegetarian meals?:
Yes

 

 

Note:  Late registration does not guarantee a banquet meal for the registrant.
Please register by February 15.

 
*What is your first area of interest?:
Second Area of Interest:
Third Area of Interest:

 

 
For Senior members only: Are you interested in judging presentations in your primary area of interest?:
I am interested.

 

 
Senior Academy and Corporate Sponsors: Are you interested in donating to student awards?:
Donate $10
Donate $20
Donate $50
Donate $100
Donate $250
Donate $500
Donate $1000
Donate $1500
Donate $2000
Select the student award you wish to contribute to:

 

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Total Fee:

0.00

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Please enter the text shown in the graphic below
Text:
     

Payment will be processed via PayPal using a credit card (Visa, MasterCard, Discover, American Express) or your individual PayPal account.  Parties who need to pay by check or PO will need to contact Andy Kasner by email to make arrangements separately at kasnera@wbu.edu.  Upon completion of payment, you will receive an email receipt from paypal in addition to one available during checkout at Paypal.  You should print this receipt for your records.

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