IMTA ANNUAL CONFERENCE AND APT US&C 2005 40th ANNUAL CONFERENCE REGISTRATION FORM

Chicago City Centre, a Holiday Inn Hotel July 31- August 3, 2005

IMTA REGISTRATION FORM

SECTION I.  FULL REGISTRATION FEES:

Registration Fee: Before April 1, 2005 (Must be post marked April 1^st to receive these prices)

_____$385, Public Sector APT US&C Member                 _____$545, Private Sector APT US&C Member
_____$485, Public Sector Non-APT US&C Member        _____$645, Private Sector Non-APT US&C Member

__ $165* IMTA Registration (Monday August 1, 2005 –Tuesday August 2, 2005 Only) 
                (*This price has been subsidized by IMTA)

Registration Fee; April 1 to June 15, 2005 (Must be post marked June 15^th to receive these prices)

_____$435, Public Sector APT US&C Member                 _____$590, Private Sector APT US&C Member
_____$540, Public Sector Non-APT US&C Member        _____$700, Private Sector Non-APT US&C Member

Registration Fee; On or after June 16, 2005

_____$485, Public Sector APT US&C Member                 _____$645, Private Sector APT US&C Member
_____$590, Public Sector Non-APT US&C Member                 _____$745, Private Sector Non-APT US&C Member

SECTION II. GUEST REGISTRATION FEES:

____ $40 per individual, Monday, August 1, 2005 Luncheon
____ $40 per individual, Tuesday, August 2, 2005 IMTA Awards & Installation Luncheon
____ $40 per individual, Wednesday, August 3, 2005 Awards Luncheon
____ $70 per individual, Wednesday, August 3, 2005 Installation Dinner
____ $135 per individual, Monday and Wednesday Luncheons and Wednesday Installation Dinner

List Name(s) of Guest(s) who you are registering for the above items:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

SECTION III.  SEMINARS REGISTRATION FEES:  (Fee for each seminar is $65 after June15, 2005)

_____ $50 Cash Handling Training Seminar                  Sunday July 31, 2005   1:00pm- 5:00pm        
_____ $45 Disaster Preparedness Seminar                     Sunday July 31, 2005    3:45pm-5:15pm          
_____ $55 Fraud and Internal Controls Seminar            Sunday July 31, 2005    1:00pm-3:30pm  

Fee includes manual and certificate of completion               

Registration Fee Section I: (insert appropriate fee from Section I)                                     $ ____________________

Registration Fee Section II: (insert appropriate fee from Section II)                                    $ ____________________

Registration Fee Section III: (insert appropriate fee from Section III)                                   $ ____________________

TOTAL REGISTRATION: (add Sections I, II and III)                                                               $ ____________________

 
Remit payment to:
    APT US&C
    962 Wayne Ave., Suite 910
    Silver Spring, MD 20910
        Phone:  301-495-5560
        Fax:      301-495-5561

REFUND POLICY: All cancellations must be in writing and postmarked prior to June 15, 2005.   These are subject to a $100.00 service charge.  Refunds will not be issued on cancellations postmarked after June 15, 2005.  To accommodate our delegates, substitutions will be accepted from the same city/firm.  A $20 cancellation fee will be applied to guest cancellations postmarked on or before June 15, 2005.  No refunds will be issued on cancellations postmarked after June 16, 2005.

Please print or type the following information as it will appear on attendance lists and name badges.  Badges are necessary for admittance to all functions.

Name: _______________________________________________________________________________________
                Last                                                                                        First                                        Casual/Familiar Name

Government or Firm: ____________________________________ Title: __________________________________

Address: _____________________________________________________________________________________
                     Street                                                                                 City/State/Province                             Zip                         

Email: _____________________________   Phone: _______________________   Fax: ______________________

Note: Each Public or private representative must register as a conference participant and may NOT attend as a guest. Use only one registration form per attendee. This form may be copied for additional registrations. All other individuals must register if they wish to attend conference meals, sessions, and social events.