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Conference Registration Form The Eleventh Annual Conference of The International Program Evaluation Network Conference Theme: RESULT-BASED MANAGEMENT AND EVALUATION 27-30 September 2011, Batumi, Georgia To register for this conference, please fill out the form below and pay the registration fee. Registration process 1. Fill out this form and e-mail it as an attached file to email@example.com 2. You will get the confirmation about the receipt of your registration form. 3. After getting the confirmation you need to pay the registration fee according to the instructions provided below. The fee covers conference materials and coffee breaks. 4. After receiving your registration fee, we will notify you about completeness of registration process by email. Participant information: Family name First Name Position Organization Postal address Phone (include area code) Fax (optional) E-mail Wire your funds through: FOR GEL TRANSFER (for residents of Georgia) TBC BANK GE96TB0654536080100003 GEORGIAN EVALUATION ASSOCIATION FOR USD TRANSFER (you have two options) INTERMEDIARY: CITIBANK N.A. 111 Wall str., New York, N.Y. 10043 SWIFT: CITIUS33 ABA: 021000089 TBC BANK’s Correspondent Account: #36127097 BENEFICIARY’S BANK: HEAD OFFICE SWIFT: TBCBGE22 VAKE BRANCH OF JSC TBC BANK 11, Chavchavadze Ave. , Tbilisi, Georgia SWIFT: TBCBGE22830 BEN’S Account: GE70TB0654536180100002 NAME OF BENEFICIARY: GEORGIAN EVALUATION ASSOCIATION ___________________________________________________________________________ INTERMEDIARY: DEUTSCHE BANK TRUST COMPANY AMERICAS 60 Wall str., New York, N.Y. 10005, USA SWIFT: BKTRUS33 ABA: 021001033 TBC BANK’s Correspondent Account: #04414200 BENEFICIARY’S BANK: HEAD OFFICE SWIFT: TBCBGE22 VAKE BRANCH OF JSC TBC BANK 11, Chavchavadze Ave. , Tbilisi, Georgia SWIFT: TBCBGE22830 BEN’S Account: GE70TB0654536180100002 NAME OF BENEFICIARY: GEORGIAN EVALUATION ASSOCIATION ___________________________________________________________________________ Important: IN the payment details section please write: «IPEN- GEA 2011 Conference Participant Registration Fee for <Your family name>» Please don’t forget to include your name to avoid mistakes! Attention!!! YOUR CONFERENCE REGISTRATION WILL BE COMPLETE ONLY AFTER THE FUNDS ARE DEPOSITED. WE’LL IMMEDIATELY NOTIFY YOU WHEN YOUR REGISTRATION IS COMPLETE. To participate in the conference and/or pre-conference workshops, please calculate your registration fees according to the table below. You have the following options: ● You may attend one of the pre-conference workshops (out of five) on 27 or 28 September 2011 ($60 or in GEL according to National Bank of Georgia exchange rate) th th ● You may attend both two days of pre-conference workshops (one on 27 and second on 28 of September) ($120 or equivalent in GEL) ● You may attend just the conference on 29–30 September 2011 ($180 or in GEL according to National Bank of Georgia exchange rate) th th ● You may attend one day of pre-conference workshops (on 27 or on 28 ) and the conference (fee $240 or in GEL according to National Bank of Georgia exchange rate). ● You may attend both two days pre-conference workshops (27-28.09.2011) and the conference (29-30.09.2011) (fee $300 or in GEL according to National Bank of Georgia exchange rate ) Note: Registration fees cover coffee breaks. Fee for lunch is not included. Participant who wants to have lunch at Sheraton Batumi Hotel must pay for the lunch ($30 per day) in addition to the registration fee. Also those, who would like to attend Reception ceremony and Gala Dinner at Sheraton Batumi Hotel, should pay the fee ($40+$40 once). Three important notes!!! ● After 12 September 2011, the late registration fees will be $70 (per day) for the workshop and $200 for the conference. ● Fees should be paid upfront via bank wire transfer. ● No cash payments will be accepted at the conference. Conference Registration Fees TOTAL $ Please copy You may choose to participate in only one the correct fee pre-conference workshop a day. All and paste into workshops take place in parallel at the Registration fees the same row same time during a day. are in US dollars below By 12 September After 12 2011 September 2011 27 September, Workshop 1. John Owen $60 $70 Professor, Centre for Program Evaluation, The University of Melbourne “Result-Based Management and Evaluation” 27 September, Workshop 2. Burt Perrin, $60 $70 Vice President EES, European Evaluation Society, Member of IOCE Governing Board “Evaluation Contribution to a Strategic Approach to Performance Improvement” 28 September, Two Half Day Workshops. $60 $70 Workshop 1. Ian Davies, President EES, European Evaluation Society Topic I. “How to Design and Carry Out a Performance Audit” Topic II. “Evaluation Function in Modern public Administration” 28 September, Workshop 2. Jean Quesnel, $60 $70 Board member of Canadian Evaluation Society and member of its Evaluation Development Committee What evaluators should know about Result Based Management 28 September, Workshop 3. Hartmut $60 $70 Sannecke, Hans-Gerd Birlenberg, Company “Taskforce” (joint facilitation) “How the Result Based Management and Evaluation Tools Work for Business Companies” Conference, 29–30 September 2011 $180 (two days) $200 Lunch (at Sheraton Batumi) $30 (per day) $40 (per day) Gala Dinner $40 $50 Reception $40 $50 Special Rate for Accommodation at Sheraton $145 $145 Batumi (single room per night)* (including VAT) (including VAT) Special Rate for Accommodation at Sheraton $177 $177 Batumi (double room per night)* (including VAT) (including VAT) Batumi City Tour $70 $80 Archeological Tour in Batumi $70 $80 Tour in Kobuleti Protected Areas and $55 $65 Botanical Garden Tour in Gonio Fortress and Keda $50 $60 Municipality Tour in Kolkheti National Park $75 $85 Eco Tour in Mtirala National Park $55 $65 Tour in Kutaisi $75 $85 Type the total amount you are going to pay $ Total: in the TOTAL box to the right and wire this amount according to the instructions above. Conference Registration Cancellation Policy If you cancel your registration via e-mail before 12 September 2011, we’ll return the funds to your account minus money transfer expenses. We cannot return any funds if you cancel your registration after 12 September 2011. You will need to book your hotel, buy your tickets and apply for a Georgian visa on your own. * Conference Participants who want to stay at Sheraton Batumi Hotel with the special rates MUST fill the special Sheraton Batumi Hotel Registration Form (available at the page of Hotel Accommodation) and send to Georgian Evaluation Association (GEA) to the following e-mail address: firstname.lastname@example.org. Special rates for accommodation at Batumi Sheraton are available ONLY for the Conference Participants ONLY through GEA! After Conference Participants wire funds for their accommodation at Sheraton Batumi to GEA account, GEA will book rooms for them. Funds MUST be transferred to the bank accounts indicated above in this registration form.
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