Museums and the Web 2011 Registration by ps94506

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									                                                                                                                                                         Museums and the Web 2011 Registration
                                                                                                                                                         April 6–9, 2011 Philadelphia, Pennsylvania, USA
                                                                                                                                                   Name:____________________________________________________________________________
                                                                                                                                                   Job_Title:__________________________________________________________________________
                                                                                                                                                   Institution:________________________________________________________________________
                                                                                                                                                   Address:___________________________________________________________________________
                                                                                                                                                   _ ________________________________________________________________________________
                                                                                                                                 City:___ _________________________________ State/Prov:_ ______________________________________________
                                                                                                                                 Postal_Code:_______________________________ Country:_ ______________________________________________
                                                                                                                                 Tel:_ _________________________________________ Fax:_ ______________________________________________
Archives & Museum Informatics, 158 Lee Ave., Toronto M4E 2P3 Canada; Conference Registration Lowes Philadelphia, Second Floor.




                                                                                                                                        _
                                                                                                                                 Email:_ ______________________________________ URL:_ ______________________________________________

                                                                                                                                 I_consent_to_have_my_contact_details_included_in_the_Registrants_List:____

                                                                                                                                 Conference Fees                                                    Extras: MW2011 Proceedings
                                                                                                                                 Full Registration                                                  (Full Registration includes 1 copy)
                                                                                                                                 (Incl. 1 ticket to each Reception and 1 copy of the Proceedings)   _     extra__     __________ _ @_$30____________
                                                                                                                                                                                                                       0


                                                                                                                                   Early (by Dec. 17)                  $600 _________________
                                                                                                                                   Regular (by Jan. 31)                $650 _________________       Extras: MW97 – MW2010 Proceedings
                                                                                                                                   Late (by Apr. 1)                    $700 _________________       _     MW2010____________ _            MW2009_ _________
                                                                                                                                   Student (by Apr. 1)                 $350 _________________       _     MW2008___________ _             MW2007_ _________
                                                                                                                                   (with valid Full Time Student ID)
                                                                                                                                                                                                    _            _
                                                                                                                                                                                                          MW2006_ _________ _             MW2005_ _________ _
                                                                                                                                   OnSite (aft. Apr. 1)                $800 _________________       _            _
                                                                                                                                                                                                          MW2004_ _________ _             MW2003_ _________ _
                                                                                                                                                                                                    _            _
                                                                                                                                                                                                          MW2002_ _________ _             MW2001_ _________
                                                                                                                                   Discounts                                                        _     MW99_ __________ _              MW98_____ _________
                                                                                                                                   (Must be confirmed by MW staff)
                                                                                                                                                                                                    _     MW97_ __________ _
                                                                                                                                   5+ Participants   -$50       ______________________
                                                                                                                                                                                                    _     _      Total_ _____ _
                                                                                                                                                                                                                        0                          _
                                                                                                                                                                                                                                          @_$20_ea._0________
                                                                                                                                   MAAM Member -$30             ______________________
                                                                                                                                   Author Honourarium*          request: yes      no
                                                                                                                                   (Request -$150 Hotel Credit)                                     Extras: Green Options
                                                                                                                                 Special Registration                                               Green Option 1
                                                                                                                                                                                                    No Conference Bag, just the Program and Proceedings
                                                                                                                                 (No Reception tickets, Proceedings or Discounts)
                                                                                                                                   One Day                $300         ______________________       _  I’d_like_the_bag________________
                                                                                                                                   (circle April 7 8       9 )                                      _  No_bag_thank_you___________
                                                                                                                                                                                                    _
                                                                                                                                                                                                    Green Option 2
                                                                                                                                 Extras: April 5 – Tours                                            Carbon Offsets for your flight; see www.carbonZero.ca
                                                                                                                                 (Separate registration required; includes lunch and transport)     _   No_thanks_ _                        _
                                                                                                                                                                                                                                          _ _x________
                                                                                                                                    Full Day Tour          $100 __________                          _   Coming_from_
                                                                                                                                    Specify Title:                                                  _   _____Australia/NZ_              _
                                                                                                                                                                                                                                   $75_ _ ________
                                                                                                                                                                                                    _   _____Europe__ _                 _
                                                                                                                                                                                                                                   $30_ _ ________
                                                                                                                                                                                                    _   _____Asia_    _                 _
                                                                                                                                                                                                                                   $50_ _ ________
                                                                                                                                 Extras: April 6 – Workshops                                        _   _____North_America_             _
                                                                                                                                                                                                                                   $20_ _ ________
                                                                                                                                 (Separate registration required; includes lunch)
                                                                                                                                   Full Day      1 x $300              ______________________
                                                                                                                                                                                                    Balance Due (US$) $0
                                                                                                                                   Specify Title
                                                                                                                                                                                                    Terms and Conditions
                                                                                                                                   Half Day ___ x $175                 ______________________
                                                                                                                                                                                                    Fees and discounts based on date payment RECEIVED.
                                                                                                                                   Title Morning:                                                   * Author’s Honorarium given as credit against conference hotel;
                                                                                                                                   Title Afternoon:                                                 requires on-time submission of paper. No discounts on Special Reg-
                                                                                                                                                        one                                         istrations. Payment must be received prior to attendance. No space
                                                                                                                                   Discount if 2 Half Day         -$25 _____________________        will be guaranteed without payment. Registration refundable until
                                                                                                                                                                                                    Jan. 31, 2011 less $75 handling fee. Registration may be transferred
                                                                                                                                                                                                    at any time before the conference, with advance notice. Canadian
                                                                                                                                                                                                    Institutions may request an invoice in Canadian Dollars. Contact
                                                                                                                                                                                                    mw2011@archimuse.com
                                                                                                                                 Payment
                                                                                                                                 Check (US$) or Money Order (US$)                                   Credit Card         ______
                                                                                                                                 Payable to Archives & Museum Informatics.                          VISA______Mastercard_______American_Express
                                                                                                                                                                                                    Number:________/________/________/________
                                                                                                                                 Purchase Order_(Enclose copy)                                      Exp._Date______/____
                                                                                                                                 Number:_______________________________________                                      _
                                                                                                                                                                                                    Name_on_Card:_ _________________________________
                                                                                                                                 Institution:______________________________________                 Signature:________________________________________
                                                                                                                                 Billing_Contact:__________________________________                 Billing_Address:___________________________________
                                                                                                                                 ______________________________________________                     _______________________________________________

								
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