CONVENTION REGISTRATION

100 Bridges: Haiku North America 2007

Hawthorne Inn and Conference Center—Winston-Salem, NC

August 15-19, 2007

First Name: _____________________________________ Last Name:___________________________________________

Please check yes below if you are a presenter

Presenter: _________Yes                                       E-mail: ___________________________________

Home Mailing Address: ________________________________________________________________________________

_________________________________________________________________________

              

Daytime Phone: __________________________________ Evening Phone: _______________________________________

 

MAKE CHECKS PAYABLE TO “Haiku North America”

AND MAIL THIS FORM WITH CHECK TO:

Visit Winston-Salem Attn: Services Department

200 Brookstown Avenue - Winston-Salem NC 27101

EARLY REGISTRATION DEADLINE: July 16, 2007

REGULAR REGISTRATION DEADLINE: August 1, 2007

After August 1, 2007 you must register on-site by 9:00am on the day of the conference. 

           If you have questions about registration, please contact:

 Kay Calzolari kcalzolari@wscvb.com or  Jennifer Evans at jevans@wscvb.com        

If you are paying by credit card, please complete the following information:

Credit Card Type: (Circle)              MC         VI           Expiration Date: ______/_______

                              Card Number: __________________________________________________________

Print name as it appears on the card: _________________________________________

Signature: ______________________________________________________________

Full Conference Registration includes a BLUE conference badge that will enable you to attend all events at the conference; the HNA banquet on Saturday night; an HNA conference anthology; and a CD of the conference video (mailed to you after the conference).

Single-Day Registration includes a YELLOW conference badge that will enable you to attend that day’s events at the conference.

Early Registration: By July 16, 2007

$255.00 Full Conference Registration

 

Single Day Thursday

$100.00

 

Single Day Friday

$100.00

 

Single Day Saturday

$125.00 (Includes banquet)

 

Regular Registration: By August 1, 2007

$295.00 Full Conference Registration

 

Single Day Thursday

$110.00

 

Single Day Friday

$110.00

 

Single Day Saturday

$130.00 (Includes banquet)

 

HNA Conference Anthology

$8.00 (One copy is included with Full Conference Registration. Otherwise each copy is $8.00.) 

 

Conference T-shirt with logo

$15.00 per shirt          Please indicate size     M       L      XL

 

Conference Tote Bag with Logo

$12.00

 

Group Photo

Cost to be determined.  Please check the HNA Website

in June for details.

 

Gift to HNA 2007

Please consider making an extra donation to Haiku North America. Your donation will be greatly appreciated and acknowledged in the conference program.

 
 

Total

$

Special Needs:  Dietary ______  Mobility ________ Sight/Hearing _______

Please Note

You will receive an email acknowledging receipt of your registration request.

Receipts for payment will be placed in conference folders distributed on-site.

Cancellation prior to Wednesday, August 1, 2007 entitles the registrant to a half refund of registration fees.

We will be unable to make refunds for cancellations after Wednesday, August 1, 2007.

REQUEST FOR CANCELLATION MUST BE RECEIVED IN WRITING.