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1o9th GFOA Annual Conference | Philadelphia, Pennsylvania | May 31–June 3, 2o15
Register
ONLINE
E-MAIL
FAX
Register online at www.gfoa.org or scan the completed registration form and e-mail it to [email protected].
You may also fax it to (312) 977-4806 or mail the form to the GFOA: 203 N. LaSalle Street, Suite 2700,
Chicago, IL 60601-1210 (payment with credit card) or 3076 Eagle Way, Chicago, IL 60678-1030 (payment with check).
MAIL
STEP 1 Conference/Preconference Registration
STEP 4 Preconference Seminar Registration
Please print or type. If you are faxing this form DO NOT MAIL ORIGINAL. Faxes are
accepted with credit card payments only. Please affix your mailing label here, and make any
changes to your record in the spaces provided below.
Preconference seminar registration and fees are separate from annual conference registration and
fees. Check the seminar(s) of your choice:
q Best Practice Trends in Public-Sector Procurement
First Name
q Strategic Planning
Friday, May 29, 2015 | 1:00 p.m. - 5:00 p.m. | 4 CPE Credits
MI
Last Name
Friday, May 29, 2015 | 1:00 p.m. - 5:00 p.m. | 4 CPE Credits
q Evolution of Financial Transparency
Title/Position
Saturday, May 30, 2015 | 8:30 a.m. - 12:30 p.m. | 4 CPE Credits
Organization/Company
q Infrastructure Finance
Saturday, May 30, 2015 | 1:00 p.m. - 5:00 p.m. | 4 CPE Credits
Mailing Address
q Security in an IT Environment
Saturday, May 30, 2015 | 1:00 p.m. - 5:00 p.m. | 4 CPE Credits
City
State/Province
Zip/Postal Code
Country
Telephone
Check rate below:
Each
Government Member
q $160
Private-Sector Member q $185
Each
Nonmember Government q $175
Nonmember Private Sector q $210
STEP 5 New Member Fees (If applicable)
Fax
Member Type* Please Check One:
E-mail Address (REQUIRED)
GFOA Membership # (if available)
Preferred Name for Badge:
q Indicate if you are substituting for a government member.
q
q
Government Member
Private-Sector Member
*Join the GFOA today and receive $25 off your conference registration fee
with a paid new membership. For new membership fee information and an
application, please visit www.gfoa.org or call GFOA at 312-977-9700. All fees payable
in U.S. funds except for Canadian governments which may pay membership dues in Canadian funds.
STEP 6 Total Fees (All fees in U.S. funds)
Name of Government Member
Conference Registration:
STEP 2 Guest Registrations
Group Discount:**
Print name(s) of additional guest(s). Please attach additional names if needed.
First Name
Preconference Seminar(s):
New member fee: Visit www.gfoa.org or call GFOA at (312) 977-9700 for fee.
Last Name
First Name
Last Name
Discount for paid new member: (-$25.00*)
(
Subtotal:
$
q Children 12 or Under: Print name(s) of child(ren) 12 or under.
Please attach additional names if needed.
First Name
$
Last Name
Closing Event: # of tickets/adults, $40.00 x
=
# of tickets/children under 18, $15.00 x
=
# of tickets/children under 5, Complimentary x
=
Total Fees:
First Name
STEP 3 Conference Registration Fees (Please check one:)
q $380
q $525
Nonmember Government
q $535
Nonmember Private Sector q $815
Student (Full-time, unemployed only)
q $130
Retired GFOA members
q$ 0
Government Member
Private-Sector Member
0
$
**You will receive a 10 percent discount on your conference registration if three or more people from
your jurisdiction are attending the annual conference (registrations must be submitted together). This
discount does not apply to preconference seminars. If you plan to sign up with 10 or more
Last Name
Early Registration
Postmarked and paid
by 2/17/15
)
colleagues, e-mail [email protected] for discounted fees.
Advance Registration
Postmarked and paid
by 4/7/15
Full Registration
Postmarked and paid
after 4/8/15
q $425
q $570
q $575
q $845
q $135
q$ 0
q $475
q $645
q $630
q $920
q $145
q$ 0
(not currently employed)
Confirmations
A copy of the confirmation and invoice will be sent as a PDF attachment via e-mail from
[email protected]. Please add this address to your allowed senders list. Register today!
Please see page 10 of the conference brochure and
www.gfoa.org for the cancellation and refund policy.
203 North LaSalle Street • Suite 2700 • Chicago, Illinois 60601-1210 • 312-977-9700 • fax: 312-977-4806 • www.gfoa.org
STEP 7 Method of Payment (Please check one:)
Payment by check: Payable to “Government Finance Officers Association”
Send to: GFOA, 3076 Eagle Way, Chicago, IL 60678-1030
q Payment by credit card: Scan and e-mail this form to [email protected];
fax: (312) 977-4806; or send to: GFOA, 203 N. LaSalle Street, Suite 2700, Chicago, IL 60601-1210
q Amex
q Discover
q MasterCard
q VISA
q
Name on Card
Card Number
Expiration Date (mandatory)
Signature
q Bill Me: Scan and e-mail this form to [email protected]; fax: (312) 977-4806; or send to
GFOA, 203 North LaSalle Street, Suite 2700, Chicago, IL 60601-1210
P.O. Number: _______________________ You must include a purchase order number.
GFOA Tax ID Number: 36-2167796
Government Finance Officers Association
Now Available
in both E-BOOK and PRINT form
GAAFR
Governmental Accounting, Auditing and Financial Reporting
Supplement
Covering:
n
n
GASB’s four new pronouncements:
Statement Nos. 67, 68, 69, and 70
New material to address COSO’s expanded
Internal Control––Integrated Framework
For more information and to order today, go to
www.gfoa.org