IAIA16 registration form

• Register online today! • Fast, easy and secure • conferences.iaia.org/IAIA16

1 | DELEGATE INFORMATION
Please fill out form completely. Type or print neatly in BLOCK letters. Be sure to include your name and organization exactly as you would like that information
to appear on your delegate badge. Pre-registration and pre-payment by 18 April 2016 is required. Registrations will not be accepted on-site.
Today’s date ______________ (month)/_______ (day)/20______ (year)

q Mr q Ms First name _____________________________________________

Last (family) name _______________________________________________________

Title_______________________________________________________________

Organization ____________________________________________________________

Address ___________________________________________________________

City ___________________________________________________________________

State/Province ________________________________
Phone +______________________________

Postal Code _____________________________

Fax +______________________________Country _____________________________________________

E-mail ___________________________ @___________________________

2 | REGISTRATION FEES (all fees in US$)

5 | SPECIAL EVENTS & PROGRAMSIAIA Member ID# ___ ___ ___ ___ ___ ___Welcome reception*

11 May # Persons: Delegates _____ Guests _____

Banquet*13 May# Persons _____@$55 = $_______

Fun Run

12 May# Persons _____@$5 = $_______

Affiliate ID# ___ ___ ___ ___ ___ ___Early Bird (by 5 February)		

Regular

IAIA member/Affiliate member................................... q $625 ........................................... q $730
Renew my membership, too!

1 Year...............................................q $110• • Price includes electronic access to IAPA.
2 Years..........................................q $209•
Contact IAIA HQ for pricing with
3 Years..........................................q $308•
paper copies of IAPA.
Non-member....................................................................... q $755 ............................................. q $860

6 | MEAL PREFERENCE
I prefer vegetarian meals

7 | PAYMENT INFORMATION

Student (proof of current enrollment required)................................................................... q $250

* Starred activities are tentative pending sponsorship.

Registration fee US$ ________
Membership renewal US$ ________
Total of activities fees US$ ________
Total amount due US$ ________

3 | PRE-CONFERENCE TRAINING COURSES
Pre-registration and pre-payment by 14 March is required. After 14 March, registration acceptance is subject to availability, instructor consent, and receipt of payment. Courses may not beswitched after 18 April.

1. Human Rights and Impact Assessment
2. Integrating Ecosystem Services
3. Mainstreaming Biodiversity in IA
4. How to Maximize the Value and Effect of SIA
5. Organized Reasoning and EIA
6. Quality Assurance in EIA
7. Resilience Assessment Tools
8. One Term—Various Meanings: SEA
9. State of the Art Sustainability Assessment
10. Structural Methods for Risk Reduction

CANCELED
9-10 MayCANCELED
9-10 MayCANCELED
9-10 MayCANCELEDCANCELED
9-10 MayCANCELEDq $475q $475q $475Pre-payment by 18 April 2016 is required. Cash payments on-site will not be accepted.
Charge to q Visa q MasterCard q American Express___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___3 or 4 digit CCV code on back of card ___ ___ ___ ___Expiration date ___ ___ / ___ ___ (month/year)
Print name on card____________________________________________

q $475

Non-IAIA16 delegates........................................................................................... q add $75

4 | TECHNICAL VISITS
Pre-payment is required for technical visits. After 14 March, registrations will be accepted on afirst-come, first-served basis until 18 April or the maximum number of paid participants is reached.
Please note the liability information.

A.
B.
C.
D.
E.
F.

q Yes

World Heritage: Mt. Fuji
FULL
EIA & Sustainable Decisions
9 May # persons ____ @$90 = $______
Ecofriendly Development
10 May # persons ____ @$115 = $______
History of Ise Grand Shrine
FULL
Past/Present/Future Yokkaichi CANCELED
Resilience Earthquake & Flood
FULL

Authorized signature __________________________________________
q Check or money order in US$ drawn on a US bank drawn enclosed.
q Wire transfer in US$. (Contact info@iaia.org for wire transfer instructions. Registrations will not be processed until full payment has beenreceived.)

8 | SEND REGISTRATION AND PAYMENTBY E-MAIL
info@iaia.org

REGISTER ONLINE
conferences.iaia.org/2016

BY FAX+1.701.297.7917

QUESTIONS?
Phone +1.701.297.7908
info@iaia.org

BY POST
1330 23rd St S, Suite C
Fargo, ND 58103 USA