Annual Meeting Registration

Western Section 104th Annual Meeting
Ramkota Best Western Hotel Rapid City, South Dakota
September 21-24, 2008

Secretary Mike Forister
Email: mforiste@wyoming.com
Fax Number: 307.638.4427

IAEI Western Section
413 W. 2nd Avenue
Cheyenne, Wyoming 82001

2008 Meeting Registration Form

Website: http://IAEI-Western.org

Attendee Information

Name:

First Name on Badge:

Last Name

First Name

M.I.

Email Address:

Address

Phone Number:

Fax Number:

City:

State

Zip-Code

Representing

Social Security Number:

(Last 4 Digits Only)
Required for CEUs

Spouse Attending (Name):

First Name on Badge:

REGISTRATION FEE	PRE-REGISTRATION (Must be Recieved by Sept 1.)	LATE REGISTRATION (If Recieved after Sept. 1)	AMOUNT PAID
Member Number	$295.00	$350.00
Spouse	$150.00	$175.00
Non-Member	$345.00	$400.00
Non-Member (Includes IAEI Membership)	$435.00	$490.00
		Total

All registration must be recieved by September 8th. There will be no at-door registration.
Please indicate if you plan to attend the following events that are included with your registration: (YES or NO)

Sunday Evening Welcoming Reception Tuesday Evening Banquet

Monday evening is on your own. Howeve, the South Dakota Chapter has made available two options. They are:
1) A bus trip to Historic Deadwood (Casinos and numerous restaurants) at no extra cost. or,
2) A narrated bus trip to Mount Rushmore Memorial to witness the impressive Lighting Ceremony. Cost $20 each.

Both trips will leave the hotel at approximately 6:30 PM.
The fee for the Mt. Rushmore trip will be collect by the South Dakota Chapter at the registration desk

If interested in either trip please indicate the number of how many will be attending.

Mount Rushmore Deadwood