NASSTRAC Spring Conference :: Online Registration Form

Online Registration Form

1. Registrant Information

First Name:
Last Name:
Name to appear on Badge:
Title:
Company Name:
Address:
City:
State:
Zip:
Phone:
Fax:
E-mail:
Type of Business:

In case of emergency contact:

Name:		Relationship:
Daytime Phone:		Evening Phone:

2. Registration

Registration Fees

Early bird conference registration must be made with full payment by Feb. 3, 2006.
Each participant must register individually (fees are shown for each individual).

	Member	Non-Member
Early Bird (before Feb. 3)	$595	$795
Regular (after Feb. 3)	$695	$895
Discounted "Shipper Buddy Rate"*	$295	$395
Additional Exhibitor Registration	$450	$450

* Note: This rate is available only for any additional attendees (members or non-members) from the same company. The organization must be a shipping organization. For more details, contact NASSTRAC at 952/442-8850.

Select Your Membership Status

	I am NOT a NASSTRACMember
	I am a NASSTRACMember
	I am a "Shipper Buddy"*
	I am an Exhibitor
	Payment Notes:

Guest Registration:

I am	bringing a guest
I am	not bringing a guest
Name of Guest/Spouse:

3. Payment Information

Card Type:	Visa
	MasterCard
	AMEX
	Check (forthcoming)

Name on card:
Card Number:
Expire Date:

Credit card charges will be billed in U.S. dollars. The payee on your credit
card statement will be identified as: NASSTRAC. Your institution will
convert at the prevailing exchange rate. Cancellations are accepted with
refunds less $95 prior to March 30, 2006. Cancellations received on or after
this date are not eligible for a refund.

Hotel arrangements must be made directly with the The Renaissance Orlando
Resort at 1-800-836-7610. Be sure to ask for the NASSTRAC rate.