2014 JHI International Conference & Annual General Meeting 22-25 October 2014 Marriott Wardman Park | Washington, DC | USA CONFERENCE REGISTRATION FORM (Please TYPE or PRINT in CAPITAL letters) DATE ______________ DELEGATE/GUEST INFORMATION Delegate Name: ______________________________________ Firm:_____________________________________________ Mailing Address: ________________________________________________________________________________________ City: _________________________________________ State: ______________ Zip Code: ___________________________ Telephone: ____________________________________ Email: __________________________________________________ Guest Name: _____________________________________ Email: _______________________________________________ Arrival Date/Time: _________________________________ Departure Date/Time: ________________________________ Delegate Name: ______________________________________ Firm:_____________________________________________ Mailing Address: ________________________________________________________________________________________ City: _________________________________________ State: ______________ Zip Code: ___________________________ Telephone: ____________________________________ Email: __________________________________________________ Guest Name: _____________________________________ Email: _______________________________________________ Arrival Date/Time: _________________________________ Departure Date/Time: ________________________________ REGISTRATION INFORMATION: REGISTRATION FEES: $1,500 USD for the first delegate: $1,350 USD for additional delegates, guests and children. All Registrations received after 20 September 2014 will be charged as follows: $1,600 USD for the first delegate: $1,450 for additional delegates, guests and children. To guarantee your delegate listing will be included in our onsite materials, your conference registration must be received by 30 September 2014. HOTEL RESERVATIONS must be made directly with Washington Marriott Wardman Park. Our room rate is $229 USD (single/double occupancy). Internet is included in guest rooms. Book your reservation as soon as possible before 30 September 2014 to guarantee this rate. https://resweb.passkey.com/go/JHIInternationalConference Guests may also call a US toll free number 1-877-212-5752 if they prefer. CANCELLATION POLICY: No refunds will be issued after 30 September 2014. Substitutions are offered at any time. Payments must be made prior to the conference in order to secure registration. JHI Headquarters 201 Chestnut Street, Floor 2-L Newark, NJ 07105 USA Tel +1-973-628-1150 | Fax +1-973-628-1155 www.jhi.com (Continued on Page 2) 2014 JHI International Conference & Annual General Meeting 22-25 October 2014 Marriott Wardman Park | Washington, DC | USA JHI Conference Credits: If you wish to use your JHI Conference Credits, please indicate below and send your form to Headquarters. You may use JHI Conference Credits for any or all attendees to any regional and/or international conference once your annual dues are paid in full. Please check with your “contact partner” to assess the number of conference credits available for your firm. Registration Fees: Registration Fees By 20 September 2014 Late Registration Fees After 20 Sept. 2014 First Delegate = $1,500 Additional Delegates/Guests /Children =$1,350 First Delegate = $1,600 Additional Delegates/Guests /Children =$1,450 Delegate(s) Additional Delegate(s) Guests and/or Children Total Registration Fees: Total Conference Credit Applied: Add 3% for credit card payments: Total Paid to JHI: $______________________________ USD $______________________________ USD $______________________________ USD $______________________________ USD $______________________________ USD $______________________________ USD $______________________________ USD PAYMENT INFORMATION Check VISA MasterCard Cardholder Name: _______________________________________________________________ American Express Card Number: ___________________________________________________ Expiration Date: ________________________________ Signature: __________________________________________________________ By signing, I agree to the cancellation and/or credit card policies of JHI. *All Credit card transactions will be assessed a 3% processing fee and total charge will appear as JHI Association Headquarters on your statement. USD Wire Transfer Beneficiary Name: JHI Association Beneficiary Address: 201 Chestnut Street, Floor 2-L Newark, NJ 07105 USA Bank Name: JPMorgan Chase Bank Bank Address:1401 Valley Road Wayne, NJ 07470 Account #: 881728927 Swift Code: CHASUS33 ABA Routing #:021000021 Our GALA DINNER will take place at the Mansion on O Street on Saturday evening. PLEASE SELECT YOUR DINNER choice from the following: (insert name(s) aside your selection). This must be completed now for all attending the GALA DINNER! BEEF ________________________________________________________ CHICKEN ____________________________________________________ FISH _________________________________________________________ DIETARY REQUIREMENTS and/or Special Notes:____________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ CANCELLATION POLICY: No refunds will be issued after 30 September 2014. Substitutions are offered at any time. Payments must be made prior to the conference in order to secure registration. Please return this completed form with payment information to JHI Headquarters by e-mail to [email protected] or fax +1-973-628-1155. If you have any questions please contact JHI Headquarters at +1-973-628-1150 Page 2
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