Attendee Registration Form (Complimentary or Additional)

Attendee Registration Form (Complimentary or Additional) March 2-3 2010 Austin, Texas Please submit one registration form per attendee. Complete all sections of the registration form and return with payment to Plastics Recycling Conference, PO Box 42270, Portland, Oregon 97242-0270 or fax to 503.233.1356. Duplicate this form when registering more than one person from an organization. If payment is made for multiple attendees attach all individual registration forms to the check. For registration questions, contact Jef Drawbaugh at 503.233.1305 or jef@resource-recycling.com. Name (as you would like it to appear on name badge) Company / Agency Name Address City / State / Zip Phone / Fax Email Title Country Check here if you require assistance, or special accommodations because of a disability, to make this program accessible to you. Someone from the conference office will contact you. Special request must be given to the conference office at least 10 working days prior to the conference. Check here if you would like a vegetarian meal for the luncheons. Check here if you would like a Kosher meal for luncheons. Check here if you are an APR member. Payment Full payment must accompany this registration application. Your confirmation will be emailed to the email address provided above. If you do not receive an email within 48hours, please resubmit your registration form. Total Payment Due: $ Check (payable to Resource Recycling) Credit Card (check one): Visa MC Plastics Recycling Conference Registration Fee: Registration includes two continental breakfasts, two lunches, refreshment breaks, conference packet and admission to all Plastics Recycling Conference sessions, tradeshow, and evening reception. Conference registration does not include lodging. All Plastics Recycling Conference sessions and tradeshow will be held at the Hilton Austin. Onsite registration is subject to a $100 processing fee in addition to the late registration fee of $440. Registration fee is per person. Received by February 12th $415 - One from your organization $440 per person - Two or more from your organization Received after February 12th $440 - One from your organization $425 per person - Two or more from your organization AMX Card Number Billing Address City / State / Zip Name on Card Signature Exp Date Country Office Use Only: JDDB CBDB Payment Badge Ribbon: platinum sponsor gold sponsor silver sponsor bronze exhibitor speaker moderator APR Member Company Cancellation Policy: Cancellations on or before February 1st will be charged a $50 processing fee. No registration refunds will be provided after February 1st. For additional information and conference updates, visit our website at www.plasticsrecycling.com.

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