2013-conference-registration-form

Page 1

Registration Form

SPONSORED BY

15% Early Bird Discount FOR MEMBERS

Educational Conference Options

FOR FASTER SERVICE, REGISTER ONLINE. WE WILL NOT ACCEPT REGISTRATIONS AFTER SEPTEMBER 13, 2013. CHARGE OF $ 15 FOR REGISTRATIONS SENT BY MAIL OR FAX.

Personal Information HRCI CERTIFICATION

PHR

COME EARLY! PARTICIPATE IN THE WORKSHOP SESSIONS AND MAXIMIZE YOUR INVESTMENT!

*EARLY BIRD

Applies only on specified packages *UNTIL MAY 31ST

ASK FOR DETAILS! SPHR

GPHR

Name___________________________________________________________ Job Title_________________________________________________________

Select the package that fits your needs. DAY

MEMBERS

Wednesday

Company/Business_________________________________________________

NON-MEMBERS

$150

$199

$ Enter Selection

Address_________________________________________________________

Government Employees

City_____________________________State______________ZipCode________

Includes Wednesday’s educational program, break, lunch at exhibitors and Welcome cocktail.

Tel. ( )________________________Fax ( )_________________________

Thursday

Payment Information For faster service, register online at http://members.shrmpr.org. Mail registration form with payment, payable to SHRM, Puerto Rico Chapter. SHRM PR does not accept PO’s. I authorize SHRM PR to charge my: VISA

MASTER CARD

Card number: _________________________ Exp.Date_____________________ Signature________________________________________________________ Name (as it appears on credit card bill) _____________________________________ Cardholder’s daytime phone number:___________________________________ If paying with American Express please enter CID Code here____________________

SHRM PR Cancellation Policy • Cancellations must be in writing and faxed to (787) 767-3828 • Cancellations will be charge a $50 administrative fee until April 26, 2013. • Fifty percent (50%) of registration will be refunded for cancellations received from April 27, 2013 through June 14, 2013. • Cancellations received after June 15, 2013, are not refundable. If a SHRM PR member transfers his or her registration to a non member, the non member must do one of two things: pay the difference of the price or become a SHRM PR member at the time of transfer.

OFFICE USE ONLY REGISTRATION I.D.______________________ BY_______ DATE____________ PAYMENT DATE___________________AMOUNT________________________ CHECK NO.______________________ DEPOSIT DATE____________________

How to Register On the web: http://members.shrmpr.org

$

$150

$399

E-Mail

AMEX

Special price

$599

Includes Thursday’s educational program, breakfast, lunch, breaks, Exhibitor’s Cocktail and dance for one person.

Friday

$399

$ Enter Selection

$599

Includes Friday’s educational program, breakfast, lunch, breaks, dinner and dance for one person.

2 days (Thu. & Fri.)

Early Bird

| After

Early Bird

$ Enter Selection

|

After

$599 $700 $900 $1,000

Includes Thursday & Friday’s educational programs, breakfasts, lunches, breaks and social activities for one person both days.

$ Enter Selection

Full Conference $765 $900 $1,080 $1,200 Include social activities $1,000 $1,180 $1,332 $1,480 for two persons Early Bird

| After

Early Bird

|

After

Includes Wednesday’s educational program and welcome cocktail Thursday’s and Friday’s full educational program and activities, Saturday Labor Law Forum and Afternoon Event.

Single Tickets Sale (Prices do not include IVU) EVENT Friday Plenary Session

$150

Thursday Plenary Session

$199

DAN THURMON PLENARY SESSION ONLY

PRICE

Enter Selection

TOTAL

$ $ $ $

JOHN FOLEY PLENARY SESSION & EXHIBITOR’S COCKTAIL

Thursday Social Activity $90

QUANTITY

$

e/a

$

Friday Dinner & Gala

$120

Saturday Afternoon

$35 adult $20 chld

$

Exhibitor’s (Thursday)

$50 e/a

$

Lunch

$60(Thursday or Friday)

$

e/a

e/a

$ e/a

SHRM membership options Keep up with your local network, join our chapter today! PR Chapter & National Dues (Combined) $365 National Dues (Already member of PR chapter) $165

$

(New member)

$200

(Additional member)

$180

$ $

(Renewals)

$150

$

PR Chapter

TOTAL PAYMENT

$

$__________________


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