Name:

Organization:

Preferred Mailing Address (Street):

City:

State: Zip:

Country:

Phone:

Fax:

Email:

Website:

How did you hear about the conference?

Select a choice Direct Mail Electronic Mail Web Site Word of Mouth Other

Race/Ethnicity:

(Your response is optional but we are committed to ensuring a diverse group of participants)

Gender (for room assignments): Gender Male Female

Would you be interested in being a Notetaker for one or more of the sessions? We are looking for people who can take clear and comprehensible notes that will later be used in writing the 2003 Conference Report.

  I would like to volunteer as a Notetaker.  (Information/instructions will be provided at registration)

Please use the space below to include a brief (50 word) bio and contact info, if appropriate. This information will be used for the conference bio list unless you specify otherwise.

Registration Fees: 
Individuals ……………………………………………… $ 150.00 (late fee)
Low-Income ………………...…………………………… $ 35.00

select fee $150.00 $35.00 (low income)

I will be paying by select one On-line credit card check

Accommodations and Food: On-site housing is available, but limited. All dorm-style rooms have 8 single (bunk) beds and a private bath. Pricing is for 4 or 8 persons per room.

FOOD: the in-house chef prepares wonderful meals and can accommodate some special diet needs. Packages include accommodations, linens, meals and snacks.

room options 4 person per room/6 meals/2 nights $130 4 person per room/9 meals/3 nights $170 8 person per room/6 meals/2 nights $100 8 person per room/9 meals/3 nights $140

I want to room with:

I would consider off-site accommodations with meal package if the Audubon Center is full, or because I need one night only accommodation with meals. select one Yes No

Insert nights you will be staying at the Center.

I will attend the Thursday night dinner and/or reception from 7-9 PM.

select one Dinner and Reception Dinner Reception Not Attending

Special Needs: Insert special needs regarding dietary, environmental, disability access & needs, etc.

TRANSPORTATION: The Audubon Center is located about two hours north of the Minneapolis/St. Paul (MSP) airport. Van shuttles will be available from the airport at these designated times only on a first come first served basis. YOU MUST reserve a space below. The cost will be $30/person round trip to be paid by Sept. 26. Please plan to arrive at least 45 min. before van pick-up.

Airport Pick-ups: Thursday, Oct. 16 -- 3:00 PM; 4:30 PM and 7:30 PM. Friday, Oct. 17 -- 11 AM – only.

Leaving Conference: (allow 2 hour travel time + check-in) Sunday, Oct. 19 -- 11:00 AM, 12:00 Noon and 1:00 PM.

Get a 10% discount on NorthWest airlines if reserved 30 days in advance (by Sept. 16), 5% thereafter.  Call: 1.800.328.1111 WorldFile NM2ZL, 7am – 7 pm CST, M – F.

Note: if arriving/leaving at other than scheduled shuttle times, you are responsible for your own transportation. Driving directions are on our website. Questions or concerns? Contact Teresa Konechne (contact info below). You will receive a confirmation and shuttle pick-up site once reservation is made and fee paid.

I am arriving by: select one Car Bus Airplane Train to the select one Audubon Center MSP airport Other

  I will need van shuttle transportation to and from the Minneapolis airport to the Audubon Center.

Arrival time and date:

Departure time and date.

Car pooling: I will have a car at the airport and could assist people with transportation needs from/to the airport

Arrival time and date:

Departure time and date.

Additional Information: