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CONFERENCE Attendee Registration October 5-6, 2011 Omni Orlando Resort at ChampionsGate, Florida _______________________________________________________________ ______________________________________________ First / Last Name (as to appear on name badge) Title __________________________________________________________________________________________________________________ Organization / Company ____________________________________________ ________________________________ ______________________________ Email Phone Fax □ I’m a member of ISRI Workshop Fees □ I’m a member of ERCC ISRI EDUCATIONAL PROGRAM Short Courses ACHIEVING CERTIFIED ELECTRONICS RECYCLER® (Tuesday, October 4, 2011) Time: 8:00AM-12:00Noon Registration Information: Please submit one Early registration (Received on or before September 16, 2011): registration form per attendee. Duplicate this form when registering more than one □ ISRI Members - $95 □ Non-Members - $125 Late registration (Received after September 16, 2011): person from an organization. If payment is made for multiple attendees attach all □ ISRI Members - $125 □ Non-Members - $150 individual registration forms to check. SAFELY OR NOT AT ALL (Tuesday, October 4, 2011) Complete all sections of registration form Time: 1:00PM-5:00PM and return with payment to the E-Scrap Early registration (Received on or before September 16, 2011): Conference, PO Box 42270, Portland, OR 97242-0270 or by fax at 503.233.1356. □ ISRI Members - $95 □ Non-Members - $125 Late registration (Received after September 16, 2011): Registration includes two continental breakfasts, two lunches, refreshment □ ISRI Members - $125 □ Non-Members - $150 breaks, conference packet, and admission to all E-Scrap Conference sessions, exhibit NCER Pre-Conference Workshops hall and evening reception. All E-Scrap US E-Scrap Laws 101: An Overview of the Key Aspects and Differences Conference sessions and trade show will be of the 25 State Laws (Tuesday, October 4, 2011) held at the Omni Orlando Resort at Time: 9:30AM – 12:00PM ChampionsGate. □ Cost: $150 On-site registration is subject to a $50 processing fee in addition to the late ERCC Pre-Conference Workshops registration fee of $475 US Dollars. Solutions for Harmonization of State E-Scrap Program Laws (Tuesday, October 4, 2011) Time: 1PM – 4PM Questions: For registration questions, contact Jef Drawbaugh at 503.233.1305 □ Free for ERCC Members x118 or by email at jef@resource- recycling.com □ $100 for non-members □ $50 for government non-members Hotel Accommodations: Hotel reservations Payment: can be made directly with the Omni Orlando Resort by calling 1.800.843.6664 or online Full payment must accompany this registration form. Your confirmation and receipt will be through the conference Web site, www.e- emailed to the email address provided above. If you do not receive an email scrapconference.com. Conference confirmation within 48 hours, please resubmit your registration form. attendees will receive a special discounted rate of $169 plus taxes. □ Check (make checks payable to Resource Recycling, Inc.) □ Credit Card (Visa, MasterCard, Amex) ______________________________________________ ______________________ Card Number Exp Date ________________________________________________________________________ Office Use Only: Billing Address (if different than mailing address) □ JD □ CB □ Payment □ Badge ________________________________________________________________________ City / State / Zip / Country ________________________________________________________________________ Name on Card ________________________________________________________________________ Signature
"CONFERENCE Attendee Registration"