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, tleatham@inda.org, 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, aleach@inda.org 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 tleatham@inda.org inda.org