ATI | Annual General Meeting 2012

 

ATI AGM Conference Registration

Name: ___________________________________________________________
Email: ___________________________________________________________
Address: _________________________________________________________
City: ____________________________________________________________
State/Province: ____________________________________________________
Country: _________________________________________________________
Postal Code: ______________________________________________________
Phone Number: ____________________________________________________
Alt Phone/Mobile:___________________________________________________

Lodging:
Unterkunft direkt beim HÖB buchen.

Registration Fee:
(Fees quoted in US dollars) Bitte ankreuzen:

__ $220 - MITGLIEDER
__ $110 - SCHÜLER
__ $320 - NICHT-MITGLIEDER

Bankett-Teilnahme am Sonntag bitte ankreuzen:
__ $36 - per person

TEILNAHME AN EINEM EINZELTAG:
__ $80 - Single day fee for ATI members (one day only permitted at this rate)

WELCHER TAG? ___ MO ___ DI ___ MI

PRE-DAY-TEILNAHME

__ JA. I will be attending the Pre-Day Sponsorship Session. ($10.00)
__ NEIN. I don't plan to attend the Pre-Day Sponsorship Session.
__ WEISS NOCH NICHT. Not sure about attending the Pre-Day Sponsorship Session yet.
__ I am a Sponsor and plan on sponsoring during the Pre-Day Sponsorship Session.

GESAMTSUMME (US$ ONLY) : $___________

BEZAHLINFORMATION:

Paid by: ___ Check/Money Order ( in US$, enclosed) OR
___ Visa ___ MasterCard Card Number: _________________________________
Expiration Date: ___/____/____
Name as it appears on card (please print): _________________________________________________
UNTERSCHRIFT: __________________________________________________________________________

Mail with your check, money order in US dollars, or credit card information to :
Alexander Technique International
Main Office
1692 Massachusetts Ave., 3rd Floor
Cambridge, MA 02138 USA

Fax ( CREDIT CARD PAYMENT ONLY): 617-497-2615
Questions: 1-888-668-8996 (toll-free in USA) or 617-497-5151 or email: alexandertechnique@verizon.net

BITTE EINE KOPIE DIESES ANMELDEFORUMALES MITBRINGEN ZUM AGM