2010 Conference Registration Form

35th Annual Conference
Gateways to New Directions
Professional and Organizational Development
Network in Higher Education
November 3-7
St. Louis, Missouri, U.S.A.

Personal Information
To navigate back and forth between registration sections, click on the appropriate link(s) above.

Step 1: Name & Contact Information

Name, badge, and mailing information (use a separate form for each person):

Name: (for POD database)

Badge Name: (your first name as you would like it to appear on name badge)

Title:

Department/Unit:

Institution/Organization:

Mailing Address:

City:

State/Prov.:

Postal Code:

Country:

Work Phone:

FAX:

Email: (A valid email address is necessary to receive receipt/confirmation/invoice)

Refund Policy: A full refund, minus $25 processing fee, will be made if cancellation is received by October 1, 2010. A $75 cancellation fee will be retained for cancellations received from October 2 – October 15, 2010. Other than in the case of personal emergency, no refunds can be made after October 15, 2010. Telephone/voicemail cancellations will be accepted, but must be confirmed in writing. Substitutions in attendees may be made at any time. Because of transportation scheduling and contracts, refunds for expeditions will be honored only if you cancel your entire conference registration before October 1, 2010.
For questions please contact:

POD Network
P.O. Box 3318
Nederland, CO 80466
Phone: (303) 258-9521
Fax: (303) 258- 7377
Email: podoffice@podnetwork.org

Name:	(for POD database)
Badge Name:	(your first name as you would like it to appear on name badge)
Title:
Department/Unit:
Institution/Organization:
Mailing Address:
City:
State/Prov.:
Postal Code:
Country:
Work Phone:
FAX:
Email:	(A valid email address is necessary to receive receipt/confirmation/invoice)