2016 AOSA/SCST Annual Meeting
June 4-June 9, 2016
REGISTRATION FORM
Embassy Suites by Hilton Portland Airport
Please submit 1 form per person; forms submitted together do not need information duplicated (address, payment, phone #, etc.)
A.
Name (as you wish it to appear on badge) / Lab/Organization/Employer/Affiliation:Address: / City, State/Province, Postal Code:
Phone Number: / Fax Number:
Email Address: / Emergency Contact with phone number (optional):
REGISTRATION FEES Late Fees Start May 16th All fees listed in U.S. Dollars
For additional registration options contact:Kelly Polzin - (202) 870-2412 ; / Fee / # / Total
PARTICIPANT REGISTRATION: (Includes Opening Session Lunch, Poster/Seed Issues Forum Reception, Social Hour, Awards Banquet, and lunch 6/5-6-9) / $400.00
GUEST REGISTRATION: (Includes Opening Session Lunch, Poster/Seed Issues Forum Reception, Social Hour, and Awards Banquet) / $250.00
Genetic Tech Workshop *Full Day* 6/4 (fee includes materials, breaks, and lunch) / $150.00
Seedling Evaluation Workshop *Full Day* 6/5 (fee includes materials, breaks, and lunch) / $150.00
Field Tour: Limited to 199 attendees; Full Day 6/7: Grass Seeds, Orchards, Specialty Seeds & Rogue Brewery Tour: Includes lunch and BBQ dinner at Rogue Brewery / $5.00
Bean Buddy Walk 6/6; (MUST check box if you plan to participate)
T-Shirts available ONLY to participants; please indicate size __S __M __L __XL __XXL / No Cost
LATE FEE: After May 16, 2015, All registrations increase $50 **meals cannot be guaranteed after May 16th; you must call-in to the office after this date to register. / $50.00
*** IF YOU PLAN TO ATTEND A WORKSHOP & THE ANNUAL MEETING YOU MUST REGISTER FOR BOTH*** GRAND TOTAL:
GUEST NAME(S) as you want it to appear on the name badge :
Food allergies and/or dietary restrictions:
PAYMENT OPTIONS:
Make checks payable to: 2016 AOSA/SCST Meeting $50.00 fee will be charged for returned checks Credit cards: Visa & MasterCard only
Credit card number: / Name of card-holder:Expiration date (Format MM/YY): / Security Code (3 digit code next to signature line):
SUBMIT FORM TO:
AOSA/SCST Administrative Office
653 Constitution Ave. NE
Washington, DC 20002
Phone (202) 870-2412 Fax (202) 330-5184