2009 Global Marine Renewable Conference Printable Registration Form
First Name________________________ Last Name____________________________ Email Address ___________________________________________________________ Company/Organization ____________________________________________________ Position/Title _____________________________________________________________ Phone Number________________________ Fax Number _______________________ Address _______________________________________________________________ City ___________________________State__________ Zip Code_________________ Would you like to be included on the registration list? Yes No (Your name and company only will be available to all attendees & sponsors; we will not allow your information to be sold or made public) Fees th Early Bird Registration - $500.00 must register before February 15 th General Registration - $635.00 after February 15 OREC Member - $400.00 for members (enter code here ____________ ) Early Bird Registration (before 2/15) General Registration (after 2/15) OREC Member
Pay by Check If you are paying by check, please make your check out to GMREC. Please mail your check and this completed registration form to: Global Marine Renewable Energy Conference c/o Henry V Events 6360 NE Martin Luther King Jr. Blvd. Portland, OR 97211 Pay by Credit Card If you would like to pay via credit card and fax-in your registration, please fax your registration form along with your credit card information to: Select Card Type: VISA MasterCard Amex Discover
Card Number: ______________________________________ Security code: ______ Expiration Date (Month/Year): _____/_____Name as shown on card: _____________________ If you have any questions about your registration or need assistance, please contact info@globalmarinerenewable.com, by phone at 1-877-463-3846 or by fax: 503-239-8556.
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