Institute of the North - ICETECH 2010 Registration form

Conference Registration Form

Conference: 09/20/2010 - ICETECH 2010
Register for the conference by completing this online form: If you have any questions about your conference registration, please phone: 1-907-771-2443
Personal Information
Name Title:
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Confirmation of registration and the breakdown of total registration fees/statement will be sent by email to the email address entered above. The original copy of conference registration will be handed out at the conference registration desk. Icetech 2010 CONFERENCE REGISTRATION Conference Registration fee includes the following for each delegate: Attendance at all sessions Icebreaker Reception Banquet Daily breakfast, lunch, coffee breaks Gift bag Alaska Quyana welcome dinner One copy of the conference proceedings on CD-ROM Icetech10 will qualify you for professional development hours.
Please select amount: $650.00 - SNAME Member Early (Before April 16/08) SNAME Membership Number $750.00 - SNAME Member (After April 16/08) SNAME Membership Number $700.00 - Non-Member Early (Before April 16/08) $800.00 - Non-Member (After April 16/08) $250.00 - Accompanying person Name of Accompanying Person $250.00 - One-Day attendance Early (Before April 16/08) Please indicate which day Sept 21 Sept 22 Sept 23 $300.00 - One-Day attendance (After April 16/08) Please indicate which day Sept 21 Sept 22 Sept 23 $300.00 - Student List school attending (full time) $0.00 - Organizing Committee $0.00 - Sponsor
Conference Events: Additional costs will be added to your registration fees and processed along with them. Cost of Accompanying Person (see below) covers all Icetech 2010 events, you will not need to purchase additional tickets.
Icebreaker Reception on September 20, 2010. Will you be attending the Icebreaker Reception? Yes No Additional Number of Tickets ($60): Banquet on September 21, 2010. Will you be attending the Banquet? Yes No Additional Number of Tickets ($85): Alaska Quyana on September 22, 2010. Will you be attending the Alaska Evening? Yes No Additional Number of Tickets ($85):
Accompanying Person Package: An accompanying person is a spouse, companion, or family member who is not attending the technical sessions. Only a registered delegate may purchase the package described below. An accompanying person package maximizes the opportunity to enjoy the Alaska experience, yet join the registered delegates in the morning and the evening. It includes 3 breakfasts, the icebreaker reception, the Quyana night and the banquet. It will also include a social program to explore Anchorage’s unique cultural and visitor centers. A full package is $250 per person. Conference Payment: Payment is REQUIRED in advance and will be processed at the time of registration when you are paying by credit card. If wanting to pay by check, your registration form must be received by The Institute of the North by September 10, 2010 Please make payable to “The Institute of the North,” and send payment to: 509 West Third Ave., Suite 107, Anchorage, AK 99501* For secure online payment, please click "Proceed to Payment" button.

Anchorage, Alaska, USA ~ (907) 771-2444 ~ (907) 771-2466 fax