IEEE/PES Insulated Conductors Committee

Fall 2013 Meeting On-Site Registration Form

Please indicate with a “Y” or “N” if you authorize the ICC to publish your full personal contact info (name, postal address, e-mail address, affiliation, employer, phone no., cell number, membership status) in the ICC Minutes Membership Roster.
Last Name: / First Name: / Middle Initial:
First Name for Badge: / Companion’s Name Badge, First: / Last:
Company:
Address:
City: / State/Province: / Postal Code: / Country:
Phone No: / Cell No: / Email: / Other Committees:
IEEE Member: / Yes: / No: / Member No. IEEE Member Number must be provided to receive member rate.
IEEE-SA Member: / Yes: / No: / PES Member: / Yes: / No: / Section Name:
Dietary Restrictions
None: / Gluten Free: / Lactose Free: / Non-dairy: / Fat Intolerance: / Kosher: / Vegetarian
(fish ok): / Vegetarian (no fish): / Vegan: / Nut Allergy:
- MEETING REGISTRATION - / Code / Number / Each / Line Total US $
On-site Registration: IEEE Member (incl download minutes) / ORM / $285.00 US
On-site Registration: Non-IEEE Member (incl download minutes) / ORN / $335.00 US
Download Fall 2013 Minutes / FM / No charge
Complimentary Registration1 – student, press, retired only / CR / No charge
Companion Registration2 (On-site registration) / GR / $60.00 US
Fall 2013 Minutes3 (Select to receive ICC Minutes on DVD) / FM / $50.00 US
Spring 2013 Minutes3 (Select to receive ICC Minutes on DVD) / SM / $50.00 US
ICC Historical Minutes (1947-2012) / HM / $50.00 US
Table Top Display 4 / TT / $350.00 US
On-site Meeting Registration Increased by $50.00; No change for On-site Companion Registration and ICC Minutes

1 Complimentary registration is for students, press, and retired (not working) individuals only. Minutes are not included.

2 Companion registration is not intended for technical attendees and does not include the technical sessions. Companion registration includes continental breakfast on Monday, Tuesday, and Wednesday.

3 Use this line to order ICC Minutes on hard copy CD or DVD in addition to downloadable minutes. Downloadable ICC Minutes are included with all paid registrations. Minutes will be available for download or sent via US mail after the meeting, once their preparation is completed.

4 Tabletop Exhibits will be located on the 3rd Level in Trinity Ballroom Prefunction.

- EVENT REGISTRATION - / Code / Number / Each / Line Total US $
November 10 Orientation Program / ONP / No charge
November 10 Reception / REC / No charge
November 11 Networking Luncheon (On-site registration)5 /

ONL

/ $55.00 US
November 12 Transnational Luncheon (On-site registration) /

OTL

/ $55.00 US
November 13 Educational Program6 AT&T Stadium Tour and Lunch (On-site registration) / OEDP / $55.00 US
November 11 Companion Tour: South Fork Ranch (On-site registration) /

OACT1

/ $70.00 US
November 12 Companion Tour: 6th Floor Museum (On-site registration) /

OACT2

/ $70.00 US
November 13 Companion Tour: George W. Bush Presidential Library (On-site registration) /

OACT3

/ $70.00 US
On-site ICC Event Registration Fees and On-site Companion Tours Increased by $10.00.

5 The Networking Lunch is complimentary for students. However, students must sign up for this luncheon if they plan to attend.

6 Includes Certificate for 0.4 CEU’s e-mailed directly from IEEE. Florida PE license holders MUST provide PE license number here:

Total Amount Enclosed: / $US Funds Only: