2011 AIRUM Annual Conference Registration Form

October 27 and 28, 2011

Sofitel Minneapolis
5601 West 78TH Street
Bloomington, Minnesota 55439

CONFERENCE PARTICIPATION INFORMATION

First Name:

Middle Initial/Name:

Last Name:

Title/Position:

Institution:

Address1:

Address2:

City:

State:

Zip code:

Phone (include area code):

E-mail address:

CONFERENCE FEES

Fees include all professional activities, Thursday continental breakfast, Thursday luncheon, break refreshments, Thursday social snack, Friday continental breakfast, and Friday lunch. Check which fee category you belong to and mail payment as directed below.

Note that there is NO on-site registration for this conference. Registrations postmarked after October 26 cannot be accepted. Conference registrations received after October 21 will be charged an additional $10.

AIRUM members

$200

AIRUM non-members

$225 - includes one-time $25 lifetime membership fee

PARTICIPATION INFORMATION AND MENU SELECTION

PLEASE CHECK THE APPROPRIATE BOXES:

This is my first AIRUM conference (check the website for possible scholarship information).
I am willing to be a session convener (introduce the presenter and session, distribute and collect evaluations).

Thursday Luncheon (please choose ONE)

I plan on attending (if checked, please indicate menu selection).

Roasted pork tenderloin with honey, apple with five-spices

Dijon crusted chicken breast enhanced with tarragon cream sauce

Butternut squash risotto with crispy onions served with a light curry cream (Vegetarian option)

I will not attend the luncheon.

Friday Box Lunch (please choose ONE)

The annual AIRUM business meeting will be held after the Friday morning sessions at the end of the conference. In order to accomodate participants with long drives ahead, we will be providing a boxed lunch that can either be "to go" or eaten at the hotel during the business meeting. Lunches will consist of a sandwich, potato salad, chips, fruit, cookie or brownie and a choice of beverage.
Yes, I would like a boxed lunch prepared for me.
No, I do not want a boxed lunch prepared for me.

Special dietary needs(e.g., gluten-free, etc.):

PAYMENT INFORMATION AND CANCELLATION POLICY

Mail payment (and registration form if not submitted electronically) to:	Cancellation Policy:
Leonard Goldfine, AIRUM Treasurer 272-2 McNamara Alumni Center 200 Oak Street SE Minneapolis, MN 55455 airumonline@gmail.com, 612-625-1481 FAX: 612-624-6057 (for POs only)	100% refund if notice received by October 21 50% refund if notice received by October 27 0% refund if notice received after October 27

Make checks payable to AIRUM

A list of conference registrants will be posted on the AIRUM web site. Upon completion of this form, you will be sent a confirmation email to the address you provided above. Remember, you must mail payment for the registration to be complete.

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