? 9th International Conference of Fire Service Women
Registration Form
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| ?Name of fire department or agency, if any: |
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?Attendee's current primary area of responsibility:
(i.e., suppression, fuels management, code enforcement, etc.)
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___ I will take part in the Martin Luther King, Jr., Historic District tour on Tuesday afternoon, 3/13.
___ I will take part in the golf outing on Wednesday afternoon, 3/14. (Golf fees to be paid on site)
Registration payment policy: Advance conference registrations must be received and paid in full (or purchase order received) by March 7. Registrations received after that date will be due at the full, on-site rate. The on-site registration fee is $450 for WFS members and non-members alike. On-site registration for pre-conference seminars will be strictly on a space-available basis, and is $165 .
The main conference registration fee includes all conference materials, the welcome reception, three continental breakfasts, dinner Thursday, luncheon Friday, and Sunday brunch. The Saturday night banquet ticket, and meal tickets for guests not attending the conference, may be purchased separately. One-day registrations do not include meals; meal tickets may be purchased separately.
Refund policy: Registrations cancelled before February 12 will be refunded in full, except for a $25 administrative fee. Registrations cancelled between February 12 and March 7 will receive a 50% refund. There will be no refund for no-shows or for cancellations after March 7. Another individual may attend in the place of a registered attendee if written permission from the person or agency paying the registration fee is provided.
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?WFS members
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?Non-members
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?Total $
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| Main conference registration fee (Includes continental breakfasts Thursday, Friday, and Saturday; Thursday dinner, Friday luncheon, Sunday brunch)
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?$275 |
?$300 |
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Saturday banquet ticket
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?$40 ? |
?$40? |
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| One-day registration, Thursday, 3/15 (No meals included)
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?$85 |
?$95? |
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| One-day registration, Friday, 3/16 (No meals included)
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??$130 |
?$145 |
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| ?One-day registration, Saturday, 3/17 (No meals included)
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?$85 |
?$95 |
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| ?Subtotal:
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9th International Conference of Fire Service Women
Registration Form, continued
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?WFS members?
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?Non-members
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Total $? |
| ?Subtotal from preceding page |
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| ?Pre-conference seminars, Wednesday, 3/14 (Important: Indicate choice of seminars on list below)
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| ?Full day |
?$125 |
?$135 |
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| ?Half day |
??$70 |
?$75 |
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| ?Extra meal tickets for guests and one-day attendees: |
| ?? Thursday dinner |
?$35 |
?$35 |
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| ?? Friday luncheon |
?$25 |
?$25 |
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| ?? Saturday dinner |
?$40 |
?$40 |
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| ?? Sunday brunch |
$20? |
?$20 |
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| ?Donation to conference scholarship fund* |
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| ?Total enclosed: |
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| ?*The scholarship fund is used to provide financial assistance to individuals who would not otherwise be able to attend the conference. All donations are tax-deductible as allowed by law.
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To register for pre-conference seminars on Wednesday, March 14, choose from the following. You may attend one all-day or two half-day seminars (one in the morning and one in the afternoon). If you plan to go on the golf outing, you will not be able to attend an afternoon seminar.
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?All-day seminars:
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?___ Moving Heavy Objects |
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?___ The ABC's of IMS: Taking Initial Command of Structure Fires |
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?Half-day seminars (morning):
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?___ Confronting Racism: White Privilege and White People's Responsibility |
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?___ Creative Confrontation |
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?___ Functional Boss Behaviors |
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?___ I-Zone Firefighting for Engine Company Officers |
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?Half-day seminars (afternoon):
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?___ Confronting Racism: Working Toward Racial Justice |
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?___ Functional Boss Behaviors (repeat) |
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??___ I-Zone Firefighting for Engine Company Officers (repeat) |
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?___ Mediating Disputes: How to Assist Others in Resolving Conflict |
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Return this form with your check (in U.S. dollars),VISA/MasterCard information, or purchase order number, to Women in the Fire Service, P.O. Box 5446, Madison WI 53705. Registrations paid by purchase order or credit card may be faxed to 608/233-4879. WFS' Federal ID# is 31-1087823.
| ?VISA or Mastercard #: |
?Expiration date: |
| ?Authorized signature (for credit card only): |
| ?Agency purchase order # |
?P.O authorized by: |
Please also print out and complete the workshop interest form to send with your registration.
Feel free to call us at 608/233-4768, or e-mail gaconf@wfsi.org, with any questions about the conference.
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