CalConnect Conference XLII June 6-8, 2018 Jorte, Tokyo, Japan Please use this form to register for the upcoming CalConnect Conference. You have a choice of payment options including check or electronic funds transfer, requesting that the Consortium send you an Invoice for payment, or payment by credit card. Attendance at CalConnect Conferences is limited to representatives of CalConnect Members, or representatives from a non-member attending a single Conference as Observers. If this will be your first CalConnect Conference, please review the Getting Started page. This form should be used to register one or more people for the Conference on a single Invoice, and paid via a single transaction. If your colleague(s) require separate invoices or will pay separately, please have them register separately. Company or Organization * Primary Contact for Participation Name * E-Mail Address * Telephone Dietary Restrictions? Additional Participants Additional Participant 1 Name E-Mail Address Dietary Restrictions? Additional Participant 2 Name E-Mail Address Dietary Restrictions? Additional Participant 3 Name E-Mail Address Dietary Restrictions? Additional Participant 4 Name E-Mail Address Dietary Restrictions? Additional Participant 5 Name E-Mail Address Dietary Restrictions? Registration Fee The fee for Conference participation is $450 per person for registrations received before 18 May 2018, and $495 for registrations received after 18 May 2018. Please enter the total registration amount for the individuals listed above: * How do you plan to pay? In all cases you will receive an invoice after registration and a paid invoice once your payment has been received and processed. Payment Type * We will pay by check or money order (must be issued by a U.S. bank) We will pay by ACH (electronic funds transfer) (please contact us for transfer details) We will pay via Paypal (send your payment to: dave.thewlis@calconnect.org) We will pay via credit card (Visa, Mastercard, American Express) and will call or fax credit card details in the near future We will pay via credit card (Visa, Mastercard, American Express) and wish to pay at the event Purchase Order If you have a Purchase Order and wish your Purchase Order Number shown on your invoice please enter it here. If you are also registering for the CalConnect Interoperability Test Event and wish to receive a single Invoice or execute a single payment transaction covering both registrations, please contact us as indicated in the response you will receive to this submission. Conference Attendance Agreement You must check the box below to confirm that you, and any other for whom this registration form apply, are familiar with and agree to abide by CalConnect rules of conduct. I confirm for myself, my organization, and any other individuals named above for whom I am acting in submitting this registration, that we have read and will abide by and conform to the relevant sections of the Calendaring and Scheduling Consortium Member Agreement and member representative Code of Conduct with regard both to attending this event, and subsequent actions resulting from our attendance at the event, whether or not my organization is a CalConnect member. Yes No I will abide by the CalConnect rules of conduct. * Before Submitting: Please review your completed participation form carefully. Once you have pressed the "SEND" button below, you will be given further information for completing the credit card transaction. What code is in the image? * SEND
