Register by Mail
(Printable form- Use your browser's print option to print this page)
The University of Alabama
Tuscaloosa, AL 35487
Please submit this entire page for your registration. For multiple registrations, please duplicate this form.
[ ]Mr. [ ]Ms. [ ]Dr. First:____________________________Middle Initial:________Last:____________________________
[ ] Enclosed is a check for $____________________________ made payable to THE UNIVERSITY OF ALABAMA
[ ] Purchase order is attached.
[ ] Charge $____________________________to credit card: [ ] MasterCard [ ] VISA [ ] American Express [ ] Discover
Card #____________________________Exp. Date (M/Y)____________________________
Security / Verification / CVV Code____________________________(Three or four digit code on back or front of credit card.)
Location of Conference:
DoubleTree by Hilton, 919 7th St, Greeley, CO 80634
Please enroll me in the following: (Program # 03-645-20)
[ ] $250 RNO Member Registration
[ ] $250 Early Bird Rate (Must be postmarked by May 1, 2020)
[ ] $175 Student Early Bird Rate (Must be postmarked by May 1, 2020)
[ ] $300 Standard Registration (non-member after May 1, 2020)
[ ] $200 Student Standard Rate (after May 1, 2020)
[ ] $25 Opening Reception Guest
OPTIONAL POST-CONFERENCE EXCURSIONS (PICK ONE:)
[ ] $100 Rocky Mountain national Park Tour*
[ ] $40 Self-Guided Tour of Estes Park, Colorado*
*See full excursion descriptions at www.irnc.ua.edu
A certificate verifying attendance and contact hours will be issued to all participants.
Note: The University of Alabama is committed to complying with the Americans with Disabilities Act. Requests for accommodation of physical and/or dietary needs should be made at least 30 calendar days in advance of the program date. Please email your request to firstname.lastname@example.org. A portion of the invoice amount for this program will go to the Capstone Lifelong Learning Foundation to support activities of The University of Alabama and the College of Continuing Studies. Need our STAARS Vendor Number? Please use VC000118827 for UA College of Continuing Studies.
Questions? Contact Sea Talantis at 205-348-3014 or email email@example.com or Mandy Guin at 205-348-6222 or firstname.lastname@example.org.