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Copyright © 2005 by The International Association for Conflict Management

IACM 2000

Conference Registration Form

St. Louis, Missouri : June 17-21, 2000

Name (last, first, middle):_____________________________________________________________________

Title: _________________________ Name for Name Badge_________________________________________

Organization:_____________________________________________________________________________

Address:__________________________________________________________________________________

________________________________________________________________________________________

City, State, Country, Postal Code:_______________________________________________________________

Telephone (work) _________________________________ Fax: ______________________________________

E-mail address:___________________________________________________________________________

Emergency contact, name/phone/country:_________________________________________________________

Please indicate how many in your party prefer vegetarian meals: _______ (if left blank, we will assume 0)

Please list any other special needs:_______________________________________________________

________________________________________________________________________________________


Conference Fees (includes Sunday dinner, Monday evening banquet, luncheons on Monday, Tuesday and Wednesday, admission to all conference sessions, and a copy of the conference proceedings). All amounts are US dollars:
Member (before May 15) $265.00 x # attending ______ = $____________
Non-Member (before May 15) $285.00 x # attending ______ = $____________
Member (after May 15) $280.00 x # attending ______ = $____________
Non-Member (after May 15) $295.00 x # attending ______ = $____________
Spouse Registration (meals only) $150.00 x # attending ______ = $____________
Optional excursion: Forest Park $35.00 x # attending ______ = $____________
Optional excursion: Batter's Eye Club/Cardinals Game $78.00 x # attending ______ = $____________
Optional contribution to the Rubin Award Fund ( $10, $25, $50) = $____________
2000 IACM dues (Institutional/Professional Member) $15.00 x # ______ = $____________
2000 IACM dues (Student Member) $10.00 x # ______ = $____________
TOTAL: = $____________
Payment:

[ ] Check/Money Order (in U.S. dollars, payable to IACM)

[ ] Visa [ ] Mastercard     Card #_____________________________________ Expiration Date:____________

Note: There will be a $25 fee for cancellations after June 1, 2000.

Signature:________________________________________

Please return this form by mail or fax with payment BEFORE MAY 15 for the best rates to:
IACM Conference
Olin School of Business
Washington U., Campus Box 1133
One Brookings Drive
St. Louis, MO 63130-4899 		   Fax: 314-935-6359
E-mail: IACM2000@olin.wustl.edu

Please note: This is NOT a hotel reservation form. Please make arrangements for your lodging directly with the Hyatt Regency St. Louis