All registrants must have a name tag for entrance to meeting events. Please print clearly the information to be used for name tag preparation:

Name of Individual(s): ______

Business Name or Agency: ______

Address: ______City: ______State:______Zip______

Registration form for Associate Members of IOGA, Agencies and Non-members

How Many? / Total Cost
Full Conference Registration - $130 ($150 after Nov. 24th)
(includes Reception with Exhibitors/Member Bash & Thaw Dinner/Fundraiser) / $
Thursday Only, December 11, Registration - $65
(includes Reception with Exhibitors/Member Bash) / $
Thursday – Reception with Exhibitors/Member Bash ONLY - $10 / $
Friday Only, December 12, Registration - $55
(does not include Thaw Dinner/Fundraiser) / $
Friday Thaw Dinner/Fundraiser Only, December 12-$40 / $
TOTAL FROM ABOVE / $
TOTAL FROM OTHER SIDE / $
TOTAL DUE / $

Payment Method: ______Check ______Credit Card (Visa or Mastercard only)

A $5 convenience fee will be added to credit card payments.

Card Number: ______Expiration Date: ______

Signature: ______CV# ______

(See Reverse)

Women of IOGA – Thursday, December 11th -- 4:30 p.m.

(All ladies attending the meeting are invited to participate in this fun time)

_____ I/we plan to attend the Women of IOGA. Reservations Needed. $5 each

Name(s): ______How Many? ______Total $______

Annual IOGA Poetry Contest -- Thursday, December 11th

Will be held during the Reception with Exhibitors/Member Bash Thursday Evening

Don’t forget to have your poem ready!

Don’t forget to submit your photos for the

Photo Contest – Thursday, December 11th

Photos must be submitted by 1p.m. on December 11th. Cost is $5 per photo, limit of 3 photos per person.

Prizes will be awarded during the Reception with Exhibitors/Member Bash on Thursday evening.

For more information and entry forms go to

www.ioga.org/meetings and events/

or call the IOGA Office 208.342.1438

First Aid Course

Thursday, December 11th, 2:00 – 5:00 p.m.

You must pre-register and pay in advance – No refunds!

______Review Course $15 each (3 hours) Name(s) ______

______Challenge Course $15 each (1 hour) Name(s) ______

Total Participants ______x $15 each = $______

Course instructor is outfitter Clint Frank, Middle Fork River Tours, IOGA Board Member and Sandpoint Firefighter.

Mail, e-mail or fax your registration to:

IOGA

P O Box 95, Boise, ID 83701

208.342.1438 Fax: 208.338.7830