Should you need to cancel your IFVP 2010 Conference or Certificate registration, you must do so in writing either by e-mail to becky@ifvp.org or by fax to 724-228-5888 by July 1st 2010. Cancellations received by July 1st, 2010 are subject to a $100 processing fee – refunds will be issued approximately two weeks after IFVP 20101. After July 1st, 2010 we are happy to accept substitutions, but no refunds will be issued

Our Room Block is FULL! All room requests will be considered on a first come, first served basis.

2010 Conference Registration Form.
Please fill in all appropriate information, fields marked with an are mandatory.

First name:
Last name:
     Preferred badge name:
Address 1:
     Address 2:
City/State/Zip/Country:
     Home/work phone:
     Cell phone:
     Fax:
Email:
     Website:

Dietary Restrictions

Vegetarian No red meat No dairy Diabetic
Other (list any allergies etc.):

Emergency and Medical Information

In case of emergency, contact:
Phone number(s):

Membership Information

IFVP Member  Non-member  New/Renewing Member

PAYMENT INFORMATION

(Register before June 16th to receive Early Bird rate)

Booking Details: Registration fee covers three (3) nights hotel and breakfast/lunch and coffee break refreshments. Extra nights outside Tuesday-Friday are not guaranteed to be available, so if you require additional nights, please register ASAP. All the prices are in U.S dollars.

Conference Attendance; I am attending the conference as a:

IFVP Member, Early Bird rate $1095
IFVP Member, Regular rate $1245
Non-Member, Early Bird rate $1175
Non-Member, Regular rate $1325
IFVP Member, Locals/Residents (no hotel room provided), Early Bird rate $845
IFVP Member, Locals/Residents (no hotel room provided), Regular rate $995
Non-Member, Locals/Residents (no hotel room provided), Early Bird rate $895
Non-Member, Locals/Residents (no hotel room provided), Regular rate $1045

Pre-conference Workshop August 3rd - Sold Out

I will attend Graphic Recording 101 Early Bird rate $225
I will attend Graphic Recording 101, Regular rate $250

Membership; I would like to begin/renew my membership for:

1 Year $100
2 Years $185
3 Years $275

Payment Method; please choose your payment option:

PayPal - Make a payment immediately after submitting your registration form (please note: there will be a 3% IFVP conference registration administration/processing fee when using PayPal)

Check or Money Order via Mail

     Please send a printout of this form and a check or money order for your total cost to:

     IFVP
     Box 4192
     Washington, PA 15301
     Please make checks payable to “IFVP”. You will receive email confirmation of your payment once received.
     Please submit your payment asap. We will hold your registration for 14 days.

Graphic recorders are needed to capture each of the conference presentations:

Please indicate your willingness to record a session, and if you are willing to do a debrief and coaching session for a new recorder:

Yes, I’m willing to record a session
Yes, I’m willing to record a session as a new recorder
Yes, I’m willing to do a debrief coaching session for a new recorder
I would like to volunteer at the conference.

Hotel / Travel Information

Please indicate your estimated arrival and departure information below:

  Arrival Departure
Date (mm/dd/yyyy):
Time:
     Airline:

Room Selection:
(Please note that our Room Block is FULL! All room requests will be considered on a first come, first served basis.)

No Accommodation Booking Required (Non Room Registration) Double; Two Beds Queen/King  Will be sharing room Smoking room

If sharing a room, name of person sharing room:

Please enter any special requirements/requests you may have regarding room booking:

Additional accommodation needed for:

Special Services/Assistance: If you require any special services or assistance at IFVP 2010, please explain below: