REGISTRATION FORM
April 22–25, 2013 | Miami Beach Convention Center | Miami Beach, Florida USA
To register, please complete this form. Copy this form for additional registrations, or register online at www.idea2013.com.
Name ___________________________________________________
(LAST NAME / SURNAME)
Title _____________________________________________
(FIRST NAME)
Organization ______________________________________________
Website __________________________________________
Address _____________________________________________________________________________________________________
City ________________________________________ State _________________ Zip _________________ Country _____________
Telephone ________________________________________________ Fax ______________________________________________
Email ____________________________________________________ Email Preference: q HTML
q Check here if your company is exhibiting.
q Text
q I am interested in exhibiting at IDEA13! Please contact me.
How Did You Hear About IDEA13?
q Email Promotion q Referral Friend/Colleague q Advertisement q Print Brochure q Other: ____________________________
You must COMPLETE EACH SHADED SECTION for us to process your registration.
Your Organization’s Primary Affiliation with the Nonwovens Industry (check only one):
53 q Machinery/Equipment Manufacturer
30 q Technical Textiles
54 q Supplier of Binders, Chemicals,
50 q Roll Goods Producer/Supplier
Adhesives, etc.
51 q Converters
55 q Supplier of Fibers, Pulps, etc.
52 q Nonwovens End User (check all that apply):
56 q Supplier of Films, Tapes, etc.
q Agricultural/Landscaping
57 q Commission Services (e.g, Dyeing,
q Apparel
Finishing, Printing, Sewing, Slitting, etc.)
q Automotive
58 q Research/Consulting
q Construction
59 q Paper/Packaging
q Diapers
60 q Health Services
q Filtration
61 q Transportation
q Geotextiles
62 q Wholesale/Retail Distribution
q Healthcare
94 q Association
q Home Furnishings
96 q Academic Institution
q Packaging
97 q Government
q Personal Care
98 q Press/Publishing
q Protective Apparel
99 q Other – specify:
q Sorbents
__________________________________
q Wipes
Primary Title or Job Function (check only one):
01 q Owner/Principal/CEO
02 q New Business Development
03 q Corporate and/or Division Management
04 q Plant Production Management
05 q Quality Control Engineering
06 q Research Development
07 q Purchasing
08 q Account Manager/Sales
09 q Consultant
10 q Other: _____________________________
11 q Marketing
12 q Engineer
13 q Financial/Accounting
14 q Office Manager/Administrative
15 q Human Resources
45 q Press/Editorial Staff
46 q Press Other Than Editorial
47 q Government
48 q Academic – Faculty
49 q Academic – Student
I would be interested in appointments with the following suppliers (please check all that apply):
q Ultrasonic/Hot Melt/Welding
q Adhesives/Binders/Sealants/Resins
q Media/Membranes/Roll Goods
q New Business Development
q Netting/Plastic/Metal
q Fibers
q Plastic/Additives
q Laminate/Films
q
q
q
q
Registration Fees:
Machinery/Pleating/Other
Equipment/Testing/Measuring/Other
Converting/Cutting/Coating
Other
Through March 31, 2013
After March 31, 2013
INDA Members Non-Members
INDA Members
(Please check boxes & circle fees)
q 3-Day Expo
$100
$140
$140
q 3-Day Conference/Expo
$675
$945
$780
q Daily Expo Pass (q Tues. q Wed. q Thurs.)
$75
$95
$100
q Daily Conference/Expo Pass (q Tues. q Wed. q Thurs.)
$410
$575
$470
q IDEA13 Reception (Sponsored by Eastman Chemical Company, Apr. 22, 7:00–9:30 pm)
$49
$49
$69
q Please check here if you have a disability that requires special assistance or accommodation to fully participate.
Non-Members
$175
$1,095
$135
$655
$69
NOTE: Please attach a written description of your needs. INDA must receive all special assistance requests by March 31, 2013 in order to accommodate.
Payment: FULL PAYMENT MUST ACCOMPANY THIS REGISTRATION
q MasterCard
q VISA
Total Enclosed $ _____________
q AMEX
q Check / Money Order (in U.S. funds drawn on U.S. Bank, payable to INDA)
Card # ______________________________
Card Expires (Month): _______ (Year): _______
Signature __________________________________________
q Wire Transfer (for instructions, please contact Tracie Leatham, tleatham@inda.org, or call 919-233-1210, ext. 126)
For all wire transfers, please reference IDEA13 and attach confirmation.
Pre-register at www.idea2013.com
Or, mail / fax this form with
payment or credit card information
to the address / fax shown here >
IDEA13 / INDA
PO Box 1288, Cary, NC 27512-1288
Phone: 919-233-1210, ext. 126
Fax: 866-847-7922 or 919-636-7908
tleatham@inda.org
NOTE: Cancellations must
be in writing and received by
INDA before March 31, 2013.
No refunds for cancellations
received after March 31, 2013.
WC