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1999 PROFESSIONAL DEVELOPMENT CONFERENCE
REGISTRATION FORM
Registration can be completed by
- Printing this page
- Downloading and printing form in Word 7.0 format
- Registering online
1999 PROFESSIONAL DEVELOPMENT CONFERENCE
Hyatt Regency Dallas - Reunion
September 3 – 6, 1999
REGISTRATION FORM
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| NAME: (please print) Last ___________________ First _________________
Middle ____________ |
| Address ___________________________________________ Office
_________________________ |
| Address ___________________________________________ Home
_________________________ |
| City, State,Zip ______________________________________ Fax
___________________________ |
| Country (if other than USA)____________________________ E-mail
_________________________ |
(Note: Above information will be used to create the attendee roster handed
out at the conference)
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| Name for badge
____________________________________________________________________ |
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Company or IEEE affiliation (for badge) __________________________________________ |
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Special dietary needs (attendee) _______________________________________________ |
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In case of emergency, contact (name and phone) _________________________________
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| My companion will accompany me. Yes/No ________ |
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Companions’ name __________________________________________________________ |
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Address: __________________________________________________________________ |
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Special dietary needs (companion) _____________________________________________
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| Codes for office use only |
| 8715 |
I am an IEEE Member Yes/No _______ IEEE
Member Number _______________ |
| 8899 |
I am not an IEEE Member, but I belong to the following engineering professional
society (e.g., |
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ASME, ASCE): _____________________________ Member Number _________________
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| 8900 |
I am an IEEE-USA PACE delegate. Yes/No _______ |
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For what IEEE entity? (Region, Section, Area, Division, Society) _____________________
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| 8901 |
I am a Graduate of the Last Decade (GOLD). Yes/No _______ |
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Representing what IEEE entity? (Section, Region, Society, Division) __________________
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| 8840 |
I am neither PACE nor GOLD, but am representing the following IEEE or IEEE-USA entity |
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(e.g.,Board, Committee) ______________________________________________________
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| 8902 |
This is my first IEEE-USA Professional Development Conference:
Yes/No _______
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| 8908 |
I wish to mentor a first-time attendee at the conference: Yes/No
_______
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I belong to the following IEEE technical societies: __________________________________ |
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___________________________________________________________________________
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REGISTRATION FEE SCHEDULE
(Check items applicable and enter amount in column on the right.) |
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Before
7/31/99 |
After
7/31/99 |
Amount
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| 8950 |
IEEE Member Registration
Includes Friday Reception for attendee and 1 guest; Saturday, Sunday, Monday breakfasts;
Saturday, Sunday lunches; all breaks; and 1 copy of the conference Proceedings. (Note:
Members of other engineering societies may register at the IEEE member rate.)
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$295 |
$325 |
$______ |
| 8951 |
Non-member Registration
Includes Friday Reception for attendee and 1 guest; Saturday, Sunday, Monday breakfasts;
Saturday, Sunday lunches; all breaks; and 1 copy of the conference Proceedings.
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$375 |
$395 |
$______ |
| 8952 |
Life Member Registration
Includes Friday Reception for attendee and 1 guest; Saturday, Sunday, Monday breakfasts;
Saturday, Sunday lunches; all breaks; and 1 Copy of the conference Proceedings.
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$150 |
$175 |
$______ |
| 8953 |
Student Member Registration
Includes Friday Reception for attendee and 1 guest; Saturday, Sunday, Monday breakfasts;
Saturday, Sunday lunches; all breaks; and 1 copy of the conference Proceedings.
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$150 |
$175 |
$______ |
| 8957 |
IEEE Member Daily Registration (Local only)
Includes breakfast, lunch, coffee breaks and 1 copy of the conference Proceedings. (Note:
Members of other engineering societies may register at the IEEE member rate.)
Dates: _______________
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$150 |
$175 |
$______ |
| 8958 |
Non-Member Daily Registration (Local only)
Includes breakfast, lunch, coffee breaks and 1 copy of the conference Proceedings.
Dates: _______________
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$200 |
$225 |
$______ |
Group Discounts are available to local companies. For information contact
the IEEE-USA Office.
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PRECONFERENCE TUTORIAL FEES
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Before
7/31/99 |
After
7/31/99 |
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| 8701 |
Project Mastery: Delivering the Best On Time and On Budget, 8 hours (includes lunch
and CEU certificate)
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$360 |
$400 |
$______ |
| 8702 |
Sharpening Your Professional Communication Skills: Writing Action-Getting E-mail,
Letters, Reports & Proposals, 8 hours (includes lunch and CEU certificate)
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$360 |
$400 |
$______ |
| 8703 |
HTML and Web Page Construction, 8 hours (includes lunch and CEU certificate)
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$360 |
$400 |
$______ |
| 8709 |
Effective Presentation Skills, 4 hours, morning (includes CEU certificate)
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$180 |
$200 |
$______ |
| 8705 |
Communication Skills for Dealing with the Challenge of Conflict, 4 hours, afternoon
(includes CEU certificate)
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$180 |
$200 |
$______ |
| 8707 |
Practical Career Planning and Job Search Techniques, 6 hours (includes lunch and CEU
certificate)
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$35 |
$35 |
$______ |
PRECONFERENCE TRAINING (no fee) – CHECK IF YOU WILL ATTEND
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| 8713 |
New PACE Leaders’ Training,
1:00 – 3:00 pm
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no fee |
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_______ |
| 8714 |
PACE Leaders’ Update,
3:00 – 5:00 pm
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no fee |
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_______ |
| 8706 |
GOLD Leaders’ Training,
1:00 – 5:00 pm
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no fee |
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_______ |
| 8718 |
Mentor/Mentee Orientation
5:15 - 5:45 pm
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no fee |
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_______ |
| FEES FOR OPTIONAL CONFERENCE MATERIALS |
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Member |
Non-member |
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| 8956 |
Proceedings,
(how many) _______________
Note that one copy is included in the Registration Fee. Check here only if you want to
purchase additional copies.
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$25 |
$30 |
_______ |
| 8954 |
CEU certificate for conference,
if desired
(To sign up on site go to the Conference Office)
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$5 |
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_______ |
| 8955 |
Myers Briggs Personality Workshop -- Questionnaire Completion
Limited to the first 30 registered to the class
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$15 |
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_______ |
| INDIVIDUAL MEAL TICKET FEES |
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# Tickets |
Cost per ticket |
Amount |
| 8784 |
Saturday, Hoedown Buffet Dinner (not included in registration fee)
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_______ |
$50 |
$______ |
| 8787 |
Sunday, Awards Banquet (not included in registration fee)
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_______ |
$45 |
$______ |
| 8781 |
Extra Guest for Friday Night Reception
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_______ |
$40 |
$______ |
| 8783 |
Saturday, Lunch
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_______ |
$25 |
$______ |
| 8785 |
Sunday, Full Buffet Breakfast
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_______ |
$25 |
$______ |
| 8786 |
Sunday, Lunch
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_______ |
$25 |
$______ |
| 8788 |
Monday, Full Buffet Breakfast
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_______ |
$25 |
$______ |
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Children’s tickets also are available. To order, contact the IEEE-USA
office.
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| COMPANION PROGRAM |
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Tutorials:
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# Tickets |
Before
7/31/99 |
After
7/31/99 |
Amount |
| 8763 |
Women of the Wild West
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_______ |
$15 |
$20 |
$______ |
| 8778 |
Belly Dancing for Fun and Fitness
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_______ |
$15 |
$20 |
$______ |
| 8779 |
Men’s Health Issues: Heart Disease, Prostate Cancer, Impotence
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_______ |
$15 |
$20 |
$______ |
| 8780 |
3 R’s of Self Defense: Resist, Retaliate, Run
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_______ |
$15 |
$20 |
$______ |
| 8782 |
Cooking Class/Luncheon (Southwestern Cooking)
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_______ |
$25 |
$30 |
$______ |
| 8790 |
Saturday Complimentary Breakfast with attendees
(6:30 – 8:00 a.m.)
Check if you will attend |
_______ |
Complimentary |
$_0.00_ |
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| TOTAL CONFERENCE FEES DUE |
$_________ |
PAYMENT METHOD
Check enclosed (payable to IEEE) __________
Money Order enclosed (payable to IEEE) __________
Credit Card (check one):
American Express __________ Visa __________ MasterCard
__________
Card Number: ___________________________________ Expiration Date:_____________________
Signature: __________________________________________________________
Total amount enclosed or to be charged:
____________________________
RECEIPT
A receipt for your payment will be mailed to you.
CANCELLATION POLICY
If written cancellation of registration is not received at the address below by August 27,
1999, a cancellation request fee of $20 will be deducted from any refund made.
??QUESTIONS?? Call IEEE-USA at 202/785-0017.
Mail or fax the completed form and payment to:
Linda S. Hall
IEEE-USA, Suite 1202
1828 L Street, NW
Washington, DC 20036-5104
Fax: 202/785-0835
Registration form may be submitted electronically by visiting the
following Web site:
http://www.ieeeusa.org/PRODEVCON |