Registration

Registration Information

Space is limited and registrations are on a first come, first serve basis.

Cancellation

Should you need to cancel, you will be issued a credit which may be used for future symposiums. Refunds are not given. If prices change you will be required to pay the difference in order to meet the current price for the event you will actually attend.

Pricing

Planning to Win organizers have negotiated an incredible rate for the 2012 sessions.

Only $1,195 - Includes Three Nights Hotel Stay!

Includes tuition, daily lunch, snacks, and Monday night social event.

Early Bird Registrants receive a $200 discount!

Seating is limited. Reserve your spot today.

Call for second-person/same company savings: 800-658-5314 x2436.

Company Information

*Company Name:	Enter your name here if you do not have a company.
*Contact Name:
*Phone Number:	Please include area code.
*Email Address:
*Address 1:
Address 2:
*City:
*State/Province:
*Zip/Postal Code:

Billing InformationSame as Company Information

*Company Name:	Enter your name here if you do not have a company.
*Contact Name:
*Phone Number:	Please include area code.
*Email Address:
*Address 1:
Address 2:
*City:
*State/Province:
*Zip/Postal Code:

Attendee Information *Use names and titles as you would like them to appear on program materials.

*Attendee Name:

*Title:

*Email:

Registration confirmation will be sent to this address.

*Symposium Date:

*TES Owner:

*Does not include E-TES

*Referred by:

InterlinkSupply Distributor
Postcard
Email
Cleanfax Magazine
LinkedIn
Facebook
Reets Drying Academy
Magazine Advertisement
Internet Search
Previous Attendee
Other

*Distributor Name:
*Salesperson:
*City & State:

Please tell us the name of the magazine
where you heard about Planning to Win.

Google
MSN Live
Yahoo!
Other

Please tell us who referred you to Planning to Win.

Please tell us how you heard about Planning to Win.

Do you have any additional attendees to register? Yes No

Attendee 2

*Attendee Name:
*Title:
*Email:	Registration confirmation will be sent to this address.
Do you have any additional attendees to register? Yes No

Attendee 3

*Attendee Name:
*Title:
*Email:	Registration confirmation will be sent to this address.
Do you have any additional attendees to register? Yes No

Attendee 4

*Attendee Name:
*Title:
*Email:	Registration confirmation will be sent to this address.
Do you have any additional attendees to register? Yes No

Attendee 5

*Attendee Name:
*Title:
*Email:	Registration confirmation will be sent to this address.
If you have more attendees to register, please contact Andrea Curtis directly at 800-658-5314 extension 2436.

Hotel Information

Hotel Stay Request:

I do not need hotel.
I am staying during the symposium dates (check in Sunday, check out Wednesday).
I would like to extend my stay.

Extended Stay Information

Please enter your arrival and departure dates:
*Friday or Saturday (before or after the event) night will cost $125 per night.

Room Occupancy

	# of rooms in Single Occupancy (1 person, not sharing)
	# of Rooms in Double Occupancy (2 people shaing 1 room)
	Triple & Quad Occupancy not allowed.

Bedding Request

One King/Queen Bed
Two/Double Beds

Special Requests (medical needs, dietary needs, etc)

Payment Information *Your credit card will not be charged until the registration information has been verified.

Card Type:
Card Number:
Expiration Date:	Month Year
Name:	As it appears on the Credit Card

Additional Information / Comments: