CalConnect Virtual Conference 2021 April 12-15, 2021 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 CalConnect 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 the CalConnect Virtual Conference participation is U.S. $50 by April 9, 2021. 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. 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. * TESTING AT THIS EVENT We will contact all participants after they have registered to determine If they are interested in or planning to test at this event. This will help us to plan for and organize testing, and also encourage other organizations attending the event to test. 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
