SETA

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2011 Spring Online Registration Form

Online Registration Form

Please complete the information in the section below. Fields with an asterisk (*) beside them are required in order to complete a valid registration.

First Name: *
Last Name: *
Badge Name:
Title: *
Organization: *
Address: *
City: *
State: *
Zip: *
Phone: * Ext.
Fax: *
Email: *
Special needs:
Food Allergies:
Comments:

Use this information below to calculate the amount to send:

$20.00 Annual Membership, July 1, 2010 - July 30, 2011
$450.00 Early SETA Member (or NCETA Member) Registration (Postmarked on or prior to February 11, 2011)
$470.00 Early SETA Member (or NCETA Member) Registration + Membership Dues (Postmark on or prior to February 11, 2011)
$500.00 Early Non-Member Registration (Postmarked on or prior to February 11, 2011)
$500.00 Members Registration (Postmarked after February 11, 2011)
$520.00 Members Registration + Membership Dues (Postmarked after February 11, 2011)
$550.00 Non-Members Registration (postmarked after February 11, 2011)

** ONLINE REGISTRATION ENDS ON March 5, 2011!
YOU MUST REGISTER ON SITE AFTER THIS DATE. **

On-site registration $550.00

PRE-CONFERENCE SESSION REGISTRATION:  Free
I will attend the Preconference session on WIA Eligibility
I will NOT attend the Pre-conference session on WIA Eligibility

DAILY REGISTRATION FEE:
Monday, March 7, $200
Tuesday, March 8, $200

Please use drop down menu to select your total amount due.

When you are ready, click the SUBMIT button below. Your official invoice will appear immediately onscreen. PRINT 3 COPIES - Mail one with your check, keep one for your records, and forward one to your organization.

PLEASE MAKE CHECK PAYABLE TO “SETA” (FEIN #64-0763625)

Send your payment to:

SETA Conferences
(FEIN #64-0763625   DUNN's #146189647)
Attn: Spring 2011 Conference Registration
P.O. Box 17991
Greenville, SC 29606
Phone: (864) 653-0663 Fax: 864-752-1521

For registration and payment information, contact Julia Hoyle at (864) 653-0663
or via email at: jhoyle@10-xgroup.com.

CANCELLATION POLICY. Completion of this registration form is considered an financial obligation. Full payment is expected unless cancelled by specified date. Cancellations received before February 11, 2011 will be subject to a $50.00 cancellation fee. Cancellations received after February 11, 2011, will be subject to the full registration fee. Substitutions will be accepted at any time.

Submittal of this registration form authorizes SETA to use photo images of all conference registrants.