CONFERENCE Attendee Registration by cuiliqing


									                                           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
                                               □    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-
                                               □    $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 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


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