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MONITOR REGISTRATION FORM
(Page 1 of 2)
108th Annual Conference & Exhibition • June 22-25, 2015• Exhibition: June 22-24, 2015 • Raleigh Convention Center • Raleigh, NC
Note: If you are interested in registering for courses or special events, please complete Page 2 of the Monitor Registration Form and submit with this page. If you plan on
registering for addition conference days, please submit this form along with the standard registration form. You may also register for standard registrations online at
http://ace2015.awma.org.
Student
Non-Student
Speaker
Last Name _____________________________________First Name_____________________________ Badge Name_____________________________________________________
Title __________________________________________ Affiliation/Employer____________________________________________________________________________________________
Address ______________________________________________________________________ Country_____________________________________________________________________
City ___________________________________________ State/Province ________________________________________ Zip/Postal Code ________________________________________
Phone _____________________________ Fax ______________________________ E-mail ________________________________________________________________________________
On-Site Mobile Phone ________________________________________________________________________________________________________________________________________
Half-day monitors receive a free same-day full registration. Full-day monitors will receive a full registration for another day of their choice.
Assignments are made on a first-come, first-serve basis. Registration benefits include admission to technical sessions and exhibits only.
Any registration fees paid prior to volunteering will not qualify for a refund.
PLEASE SELECT THE SESSION TIMES YOU WOULD LIKE TO MONITOR
Morning session volunteers begin at 7:15 a.m. and afternoon session volunteers begin at 12:30 p.m.
Monday, June 22
KEYNOTE SESSION
Tuesday, June 23
MORNING SESSION
AFTERNOON SESSION
Wednesday, June 24
MORNING SESSION
AFTERNOON SESSION
Thursday, June 25
MORNING SESSION
AFTERNOON SESSION
Please indicate specific session preferences to monitor, if any:
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________
If you are volunteering to monitor for a full-day (or more), please select which alternate day(s) you would like to use your free day registration:
Tuesday, June 23
Wednesday, June 24
Thursday, June 25
Registrar, Air & Waste Management Association • One Gateway Center, 3rd Floor • 420 Fort Duquesne Blvd. • Pittsburgh, PA 15222-1435 USA • Phone: +1-412-232-3444 • Fax: +1-412-232-3450
Email: [email protected]. Please do not mail AND fax.
MONITOR REGISTRATION FORM
(Page 2 of 2)
108th Annual Conference & Exhibition • June 22-25, 2015• Exhibition: June 22-24, 2015 • Raleigh Convention Center • Raleigh, NC
# Tickets
Attendee
SPECIAL EVENTS
NETWORKING
Ticket
Cost
Total
Cost
PROFESSIONAL DEVELOPMENT COURSES
Payment must be received on time to receive the advance rate.
(for more information please visit the conference website)
Scholarship Golf Tournament: Lonnie Poole Golf Course (Sunday)
ADVANCE RATE
AFTER MAY 20, 2015
Member NonMember Member
NonMember
$100
1 DAY COURSE
A&WMA Lake Johnson 5K Fun Run/Walk and Fun Fest (Monday) ‡
$20
AIR-173
Women’s Professional Development Luncheon (Tuesday)
$45
AIR-240
Grand Reception (Tuesday)**
$50
AIR-295
Young Professional / Student Networking Reception (Wed.) - YP
$20
AIR-299
Young Professional / Student Networking Reception (Wed.) - Professional
$35
CTAIR-145
Young Professional / Student Networking Reception (Wed.) - Student
$15
EMGM-285
Honors & Awards Ceremony and Luncheon (Wednesday)**
$50
EMGM-345
TECHNICAL TOURS
$700
$600
$800
EMGM-351
(for more information please visit the conference website)
NC Dot Rail Yard and Engine Emissions Testing Technical Tour (Monday)
$20
US EPA Technical Tour (Tuesday)
$28
NC State Hunt Library, FREEDM Center, and Env Eng Lab (CCEE Lab) (Wed.)
$40
RALEIGH TOURS
$500
WASTE-245
(for more information please visit the conference website)
PLEASE CONSIDER THE FOLLOWING CHARITABLE DONATIONS
Raleigh Area Tour (Monday)
$28
Durham Area Tour (Tuesday)
$65
$_______ A&WMA Student Scholarship Fund
NC University Hunt Library, Meymandi Concert Hall, Tour (Wednesday)
$20
$_______ IPEP Foundation: “Helping Professionals Worldwide Achieve the Credentials They Deserve”
NC Museum of Art and Downtown Museum Tour (Wednesday)
$30
$_______ A&WMA Scholarship Raffle Drawing; Tickets are: 1 for $5 or 5 for $20
**Ticket included in full registration
Subtotal $ _______________________
‡ Fun Run/Fest: Please be aware that if there is inclement weather, all registration costs will be donated
to the Scholarship Fund. Refunds will not be given.
$_______$20 Carbon Offset Donation to NC GreenPower
Subtotal $ __________
Registration Information
Please note all monetary amounts are in U.S. dollars. This form is not for on-site use. Persons under 18 years are
not permitted on exhibit floor. Pre-registration confirmations will be sent. Badges will be distributed on-site at
the Raleigh Convention Center. Written refund requests must be received by June 5, 2015. Refund requests
received on or before June 5, 2015 will be issued less a $75 cancellation fee.
Grand Total/Payment Type
Card Number _________________________________________________________________________________
Check (attached)
Exp. Date ___________________ CCV Number_______________
Purchase Order (attached) Name ___________________________________________________
American Express
Signature ________________________________________________
Discover
A&WMA Federal Tax ID#25-6048614
Mastercard
VISA
Grand Total of All Categories: $
__________________________
Registrar, Air & Waste Management Association
One Gateway Center, 3rd Floor
420 Fort Duquesne Blvd.
Pittsburgh, PA 15222-1435 USA
Phone: +1-412-232-3444
Registrar,
Air & Waste Management Association
Fax: +1-412-232-3450
Please do not mail AND fax.
One
Gateway
Center, 3rd Floor
Email:
[email protected]
420 Fort Duquesne Blvd.
Pittsburgh, PA 15222-1435 USA
Phone: +1-412-232-3444
Fax: +1-412-232-3450
Please do not mail AND fax.
Email: [email protected]