REGISTRATION FORM Tuesday - Friday June 16-19, 2015 Hotel InterContinental Buckhead

advertisement
REGISTRATION FORM
Tuesday - Friday | June 16-19, 2015
|
Hotel InterContinental Buckhead
|
Atlanta, Georigia USA
To register for WOW2015, please complete the form below. Copy this form for additional registrations, or register online at inda.org.
By registering early, you qualify for significant savings from the regular registration fee.
Last Name/Surname
First Name
Job Title
Organization
Address
Website
City
State
Telephone
Zip
Country
Mobile
Email
Please make selections in each section for us to process your registration.
Your Organization’s Primary Affiliation with the Nonwovens Industry
(check all that apply):
 Wholesaler/Retail Distributor
 Computer Management Systems
 Supermarket, Retail Store
 Testing Services
 Consulting, Research
 Association
 Paper, Packaging Manufacturing
 Health Services
 Academic Institution
 Government
 Press/Publishing
 Technical Textiles
 Nonwoven Producer/Supplier
 Converter/Fabricator/End Product Manufacturer
 Brand Owner/Branded Product
 Machinery, Equipment Manufacturer, Supplier
 Supplier of Adhesives, Binders & Chemicals
 Supplier of Resins, Fibers & Pulps
 Supplier of Paper & Packaging
 Supplier of Other Materials (Films, Tapes, Netting)
 Commmission Services
Primary Title or Job Function (check only one):
 Principal/CEO/President/Senior Leadership
 New Business/Product Development/Tech. Scout
 Director/Division Management
 Manufacturing/Production/Operations Management
 Quality Control/Assurance Engineering
 Research & Development
 Purchasing
 Account Manager/Sales Management
 Consultant
 Marketing/Product Management
 Engineering/Applications/Process
 Financial Accounting/Comptroller/Business Analyst
 Office Manager/Administrative Assistant
 Human Resources
 Information Systems
 Press/Editorial
 Press/Other than Editorial
 Government
 Academic – Faculty
 Academic – Student
Registration Fees*
By May 15, 2015
After May 15, 2015
INDA Member
 Full Conference
 Networking Registration (Coffee Breaks and Receptions only)
 WIPES Academy Training Course June 15-16, 2015
 $ 1,250
 $ 525
 $ 1,895
 $ 1,500
 $ 625
 $ 1,895
Non-Member
 Full Conference
 Networking Registration (Coffee Breaks and Receptions only)
 WIPES Academy Training Course June 15-16, 2015
 $ 1,795
 $ 695
 $ 2,695
 $ 2,150
 $ 795
 $ 2,695
 Welcome Reception, Tuesday, June 16 (RSVP needed, no additional cost)
 Dine with Industry Thought Leaders, Thursday, June 18, 2015
$
$
$
$
0
75
0
75
* Discount Pricing:
n First-time attendees or attendees returning after 2011 receive special discount pricing
n Company large group discounts with five or more
n Wipes Academy registrants receive a $250 discount off WOW full conference Member/Non-Member registration fees.
Payment (full payment must accompany this registration)
 MasterCard
 VISA
 AMEX
 Check/Money Order (in U.S. funds and drawn on U.S. bank, payable to INDA)
Total Enclosed $
Card #
Card Expires
Billing Zip Code
Phone or Email
Signature
(month)
/
CVV Code
(year)
 Wire Transfer (for instructions, please contact Tracie Leatham, [email protected], or call + 1 919 459 3700 x3726)
For all wire transfers, please reference WOW2015 and attach confirmation.
 Please check here if you have a disability that requires special assistance or accommodation to fully participate.
NOTE: Please attach a written description of your needs. INDA must receive all special assistance requests by May 15, 2015 to make accommodations.
Hotel Reservations To make your hotel reservation, visit inda.org/events/wow15. Hotel deadline: May 15, 2015.
INDA is offering discounted rates as long as rooms are available. Contact Andreana Leach, [email protected] for questions.
NOTE: Cancellations must be in writing and
received by INDA before May 15, 2015.
No refunds for cancellations received after
May 15, 2015.
Pre-register online at inda.org or send this form with payment or
credit card information to the following address:
WOW 2015/INDA
PO Box 1288
Cary, NC 27512-1288
Phone: + 1 919 459 3700 x3726
Domestic Fax: + 1 866 847 7922
International Fax: + 1 919 636 7908
[email protected]
inda.org
Download
Related flashcards
Create Flashcards