11th IPEN conference registration form eng by Z13tl82

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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 conference@eval-net.org
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 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 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:
mshashviashvili@evaluation.org.ge. 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.

You will need to book your hotel, buy your tickets and apply for a Georgian visa on your own.


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.

								
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