2013 Anchor Leadership Summit Registration Form

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2013 Anchor Leadership Summit Sheraton New Orleans, July 10 - 14, 2013 Anchor

Anchor Advisor

(FIRST NAME)

Registration Fee $185 [Registration Fee includes General Sessions, Business Meetings, Anchor Materials, 2 Luncheons & Pizza Party. Anchor Tours additional charge.]

(LAST NAME)

Parent/Chaperone

Registration Fee $50 [Registration Fee includes Business Meetings, Anchor Materials & Pizza Party. Luncheons and Anchor Tours additional charge.]

(PREFERRED NAME FOR BADGE)

MAILING ADDRESS CITY

STATE

ZIP

DAYTIME PHONE

EXTRA LUNCHEON TICKETS $60 each

PREFERRED EMAIL ADDRESS

CELL PHONE

Anchor Club of (specify above)

DISTRICT

Do you require special assistance? If so, please describe.

JULY 8

Friday

“Celebrate Excellence”

#____

Saturday

“The Brilliance of Service, The Gift of Self”

Emergency Contact Name & Phone Number

ARRIVAL DATE:

Please specify number of additional tickets required, and add to registration total.

JULY 9

#____

JULY 10

DEPARTURE DATE (please specify):

Chaperoned Anchor New Orleans Tours Please indicate number of tickets required. Early registration required as space is limited.

Voodoo Tour • Wednesday, July 10th

$20/ea #____

Touted as one of the hottest events for teens in New Orleans!

New Orleans School of Cooking • Friday, July 12th

$35/ea #____

DINNER EVENT: INCLUDED IN ANCHOR REGISTRATION FEE Learn how to create [and EAT] New Orleans famous’ creole cuisine from some of the best and most entertaining chefs in New Orleans.

IMPORTANT HOTEL INFORMATION In order to avoid being charged an extra $35 by the hotel, please be sure to book your room in one occupant’s name and ONE OCCUPANT’S NAME ONLY. Many hotels are currently charging an extra $35 fee if rooms are booked in more than one name. This is a charge you can and should avoid. The single person in whose name the room is booked is responsible for picking up all keys for any additional occupants at check-in.

Room rates at the Sheraton New Orleans hotel are $139 plus tax per night for conference attendees. The rate is good for three days prior and three days after the event. Parking charges are $26.60/per day which INCLUDES the discount given for conference attendees. If you choose to stay at a hotel OTHER than the convention hotel, please add $100 to each registration fee. Our complimentary meeting space is based on the number of Pilot rooms sold at the convention hotel. CANCELLATION POLICY: Registration fee - less $75.00 handling charge - will be refunded if your written cancellation is received by Pilot International Headquarters by June 1, 2013.

Please fill out the following summary to determine your registration fee total. Enclose a check for the total amount OR complete the required credit card information box at the bottom of this page. Registration is not complete until payment is received. Please contact the hotel directly to reserve and pay for your room.

$_____

Basic Registration Fee Amount:

+ $_____

Late Fee (If Applicable): Extra Luncheon Ticket Amount Total: #___

@$60/ea =

TICKETS

+ $_____

Optional Guided Tour Ticket Amount Total: #___ @$____ /ea = + $_____ TICKETS

Add $5 if paying by credit card:

+ $_____

REGISTRATION TOTAL: = $_____ CHECK ENCLOSED: PAYING BY CREDIT CARD: *** See information below. ***

Send one completed Registration Form for each individual registering to: Pilot International Headquarters, 102 Preston Court, Macon, GA 31210, or FAX (478) 477-6978, or register online at www.pilotinternational.org (click on the “2013 PI Convention” heading). Checks payable to Pilot International or applicable Credit Card information as requested on the Registration Form must accompany registration. Hotel reservations may also be made online through the Pilot International website, or you may call Sheraton New Orleans (1-888-627-7033).

Complete if paying by Credit Card (add $5 to total amount for credit card processing fees): VISA

MASTERCARD

AMERICAN EXPRESS

Account Number

Exp. Date

Name on Card

CSC#

Club ____________ Dist. __________ Personal __________________________

2013 Anchor Leadership Summit Registration Fee Summary

Registration # ___________ Check # __________ Amt. __________

Registration Fee $235* [Registration Fee includes General Sessions, Business Meetings, Anchor Materials, 2 Luncheons, Cooking School Tour & Pizza Party] * After June 1 - $352.50

Office Use Only:

REGISTRATION FORM


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