WAPT 34th Annual Conference Trade Show Conference Registration Form

Document Sample
WAPT 34th Annual Conference Trade Show Conference Registration Form Powered By Docstoc
					                  WAPT 34th Annual Conference & Trade Show
                        Conference Registration Form
                      June 27 – 30, 2010, Yakima Convention Center
The mail and e-mail information you provide below will be listed in our database as your primary
address for ALL of your WAPT communications. PLEASE PRINT


First Name                                               Last Name


School District, Agency or Company                                                                 Title


Mailing Address                                  City, State, Zip


Phone                                                       Fax

__________________________________________________________________________________________________
E-mail address


WAPT Registration Categories: Full conference registration includes $50 membership dues for
2010.
                                                                    Early Bird Rate                Standard Rate
                                                                    (before May 31st)              (after June 1st)
____ Full Member Conference Registration Fee (Sun-Wed)                    $215                         $245
     (Includes conference meals listed below for registered attendee)

____ Vendor Show (box lunch included)                                             $ 50                $ 65


Meals: (Meals listed below are included with full member conference registration) If you require additional tickets,
please order below. Indicate number of tickets needed for each meal. Meal tickets are limited on-site, so please plan
accordingly.)

        ___ Sun-Awards/$23               ___ Mon-Box Lunch/$13                    ___ Wed-Brunch/$13



Please Let Us Know………
Are you a first time WAPT conference attendee?                            YES             NO
Are you a past WAPT President?                                            YES             NO
Are you interested in helping out at the registration desk?_________

Food Allergies or Special Requests:
WAPT Membership Dues:
If you are registering for the 2010 Annual Conference, your membership dues are already included in your registration
rate. If you do not plan to attend the conference and wish to pay for your dues at this time, please indicate your member
status below and submit the appropriate payment. This will eliminate the need for us to send you a paper bill for renewal.
We thank you for your continued support in WAPT.

____ General $50
Any persons who are regularly employed or active in, responsible for or concerned with a school transportation system
(public or private)

____ Associate$50
Those persons responsible for or concerned with pupil transportation, who are regularly employed by a city, county, state, or federal
agency.

____ Affiliate $125
Firms, persons, partnership, and corporations engaged in the business of manufacturing, producing, distributing, or supplying school
buses, school bus bodies, school bus chassis, school bus components, or school bus equipment, tools and supplies incidental to the
operation and/or maintenance of pupil transportation.

Payments must be made by Check, Purchase Order/Voucher payable to WAPT, or Credit Card.

Check #                     Purchase Order/Voucher #___________________________

Credit Card #                                         Name on Card__________________________ Expiration Date________

Statement Billing Address_____________________________________________________________________________

                                                               Total Amount Due                                 $

Cancellation Policy:            In order to receive a full refund, cancellations must be received no later than May 24,
2010. Cancellations after this date will be refunded minus a $25 administrative fee, unless approved by the board.




                                 Mail or Fax completed registration forms to:
                           WAPT ~ Peggy Emhoff ~33 S. 2nd Ave., Yakima, WA 98902
                           Phone: 1-888-927-8482, ext. 703 ~ Fax: (509) 576-3794
                                          peggy.emhoff@esd105.org