Convention 2005 — Building Your Support Network
Registration
The registration fee includes all scheduled activities, workshops, conference materials, food functions, and a convention gift. Please note: you must be a fully-paid delegate or fully-paid spouse/partner to participate in Convention general sessions and workshops.
WPPA members and their spouses/partners may register as paid delegates for one day, either Saturday or Sunday, at a reduced fee of $70. The one-day fee includes all activities for that one day, but does not include the convention gift.
Local: ____________________
Total Number of Members in Local: ____________________
Number of Authorized Voting Delegates: ____________________
(One
delegate per 15 members or fraction thereof, maximum of 10.)
Name of Contact Person: ___________________________________________
Daytime Telephone: ___________________________________________
| Designation: | |||
| Voting Delegate | (D) | $130.00 | |
| Alternate Delegate | (A) | $130.00 | |
| Non-Voting Delegate | (N) | $130.00 | |
| WPPA Member Spouse/Partner | (MS) | $130.00 | |
| Saturday Lunch | (SAT-L) | $15.00 | |
| Saturday Dinner | (SAT-D) | $20.00 | |
| Sunday Lunch | (SUN-L) | $15.00 | |
| Banquet | (B) | $30.00 | |
(Please designate all registrants using the codes listed above. An “alternate delegate” is one who is authorized to vote in the absence of a voting delegate. Any delegate not authorized to vote would be a “non-voting” delegate.)
Last Name: ___________________________________________
First Name: ___________________________________________
Designation: ___________________________________________
One-Day Registration (Sunday or Monday)
Banquet Choice (see Convention 2005 Banquet Entrees For Sunday, May 15)
Total Prepaid Registration Fees $______________
(Make checks payable to: WPPA)
__ Check here if this is the first time you have ever attended a WPPA Convention.
__ Check here if you plan to give blood at the WPPA-Sponsored American Red Cross Blood Drive on Saturday, May 14, 2005.
Yes, our local president or designee, ____________ (print name), will attend the Local Presidents’ Breakfast on Sunday morning, May 15, from 8:00 to 9:00 a.m.
Mail registration form and check to: WPPA Convention, 340 Coyier Ln., Madison, WI 53713
Registration/Cancellation Policy: All registration fees are due at time of registration. Refunds requested up to and including May 9 will be assessed a $25 processing fee. After May 9, fees are transferable but non-refundable.
Early Bird Door Prize: There will be a door prize drawing from only fully-paid registrations postmarked by May 2, 2005! You do not have to be present to win.
Additional drawings will be held for all other gifts. To qualify, you must turn in your fully-paid delegate or fully-paid spouse/partner name badge at the closing session on Monday morning, May 16. You must be present to win.
Questions? Call 608-273-3840 or 800-362-8838.
