pdf brochure - Northwest Mining Association

NWMA’s 2013 Exhibitor Advanced Discount Registration Form
ONE REGISTRATION PER FORM Return to NWMA by Fax: (509) 623-1241, or mail to NWMA, 10 N. Post St., Ste. 305, Spokane, WA 99201-0705, USA.
To quality for Advance Registration Pricing, your completed form must be received by NWMA no later than Sunday November 17, 2013
Exhibiting Company: Booth #
Name (as you want it to appear on the badge)
Title:
Company (if different from above):
Address:
City: State/Province: Postal Code:
Country:
Phone:
Email:
Spouse Name (complete & check box below for complimentary exhibit hall badge - MAY NOT BE USED FOR EXHIBITOR):
Annual Membership Dues - you must join, renew or have a current membership to get discount rates
New Renew
Individual Active m m $ 105
Retired Senior (65 and over & not working) m m $ 25
Full-time University Student (ID required) m m $ 25 Membership Fee
m My membership is current -----
Short Course Registration -(some student discounts available on short courses - contact NWMA)
m Minimizing Permitting Pitfalls & Delays on Federal Lands (2-day course) $ 225
m Standardized Cost Estimator (2-day course) $ 450
m Integrated Exploration Workflows w/ Esri & Geosoft ArcGIS Software (2-day course) $ 450
m Heap Leaching Technology (1-day course) $ 275
m Principles of Mineral & Metallurgical Processing (1-day course) $ 275
m Geophysics for Geologists (1-day course) $ 275
m Shotcrete Underground Support (1-day course) $ 275
m Portable XRF -Principles & Radiation Safety & Case Studies (1-day course) $ 275
m Grass Valley Historic Mining District Tour (1-day bus tour) $ 150
m I am a Short Course Chair/Speaker (check course box above) No Fee Short Course Fee
Exhibitor Full Registration (includes technical sessions, exhibit hall & social functions) - Exhibiting companies are allotted 2 free passes per booth space
Choose one...
Member or
US Gov’t Non-Member
m Full Registration (I am using 1 of the 2 per booth space passes) No Fee No Fee
m Additional Paid Registration (use if allotment is full) $ 300 $ 535
m I am an Exhibitor & Session or Short Course Chair (does not count against allotment) No Fee No Fee
m I am an Exhibitor & Technical Session Speaker * (does not count against allotment) No Fee No Fee
* enter session name: Tech Session Reg Fee
Exhibit Hall Only Registration (includes exhibit hall & social functions) Exhibiting companies are allotted 2 free passes per booth space
m Exhibit Hall Pass (I am using 1 of the 2 per booth space passes) No Fee No Fee
m Additional Paid Exhibit Hall Pass (use if allotment is full) $ 75 $ 75
m Complimentary Spouse Exhibit Hall Pass* (spouse will have separate packet) No Fee No Fee Expo Only Fee
*MAY NOT BE USED FOR EXHIBIT HALL PASS
Meal and Drink Tickets
m Special food requirements
Quantity $
Wednesday
Welcoming Luncheon (Keynote speaker ~ Perry Pendley, MSLF) @ $45 ea =
Exhibit Hall Sandwich Lunch (walk around lunch) @ $15 ea =
Thursday
Industry Outlook Luncheon (featured speaker luncheon) @ $45 ea =
Exhibit Hall Sandwich Lunch (walk around lunch) @ $15 ea =
drink Tickets (Redeemable at NWMA Exhibit Hall Bars) @ $ 6 ea = Meal & Drink Tickets
TOTAL AMOUNT DUE AND FORM OF PAYMENT Total Amount Due $
Method of Payment: m Check mVisa mMasterCard mAmerican Express mDiscover
nwma deposit info only
m PO (Government Agency)
Credit Card Number
Exp Date Authoriz #
Name as it Appears on Card
Cardholder Signature
Cardholder Email
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Northwest Mining Association’s 119th Annual Meeting Exposition & Short Courses