Annual Conference Registration Form

   November 5-11, 2004  ● Adams Mark, Dallas, Texas 

Program:
Posted at www.iaem.com

Registration Fee:
$445 – non-member
$395 – IAEM member
$200 – IAEM student member
$200 – spouse
$25 – visit exhibit only (per day)
Day rates also available

Program Includes:
Handouts, (2) continental breakfasts, (3) lunches, breaks, (3) receptions, & (1) dinner

Accommodations:
Adams Mark Dallas
400 N. Olive
Dallas, TX 75201

Hotel Phone:
214-922-8000
800-444-2326

Group Name:
International Association of Emergency Managers

Room Rate:
$149 + 15% tax Single
$169 + 15% tax Double
$189 + 15% tax Triple

To receive this special room rate contact the hotel by October 1.

Transportation:
Below are estimated fees (one-way):

Dallas Fort Worth
Super Shuttle = $15.75
Cab = $38.00

Love Field Airport
Cab = $18.00 

Who should attend: members of IAEM, disaster professionals, and other officials with a role in homeland security and emergency management.

Conference Theme – “Collaboration: The Key to Success in Emergency Management.”
The IAEM Annual Conference purpose is to provide a forum for current trends, topics and the latest tools and technology in emergency management and homeland security, and to advance IAEM committee work. Sessions encourage stakeholders at all levels of government, the private sector, public health and related professions to exchange ideas on collaborating to protect lives and property from disaster.

For more information: 703-538-1795 www.iaem.com

Select your registration:

Non-Member

IAEM member

Non-member

IAEM student member

Spouse

Visiting Exhibit Only

IAEM Annual Dues Payment:

Oct. 2004 – Sept. 2005 $160 (to qualify for the $50 registration member savings)

Amount enclosed (or to be invoiced)

$

Are you a CEM?

Yes    No

Housing Cost Sharing:

Please add my name to list of those seeking to share a hotel room/split the cost.

Name:

Nickname:

Title:

 

Organization:

 

Address:

 

City/St/Zip:

 

Phone:

Fax:

Email:

Spouse Name:

Spouse Nickname:

Payment Method:

Full Name on Credit Card:

 

Credit Card Number:

 

Expiry Date:

(mm/yy)

Cancellations received in writing 14 days prior to the event will be granted a 75% refund.  No refund or credit will be granted for requests received less than 14 calendar days prior to the event. If you do not cancel your registration in writing and do not attend, full fees are due; you may however, send a substitute in your place.  Participation in IAEM events and all associated activities is at individual’s own risk.