2024 INTERNATIONAL CONVENTION REGISTRATION July 12 – 14 Full Convention participation First Name First Last Name First Gender Male Female Address Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands PhoneEmail <b>DO NOT Include My Contact Info</b> DO NOT Include My Contact Info We will prepare a list of contact information to share among those attending the convention. Please check if you DO NOT wish your information to be included.<b> DO NOT Include Photos of Me</b> DO NOT Include Photos of Me We will share photos of the convention with those attending and use them in team communication. Check if you DO NOT wish to include your photo.Select One or Two Boxes Below, as applicable: Complete ONE: I am a team member I am a participant attending Beginning Experience program(s) I am a former team member (alumni) I am a current member of the International Board of Directors I am a former member of the International Board of Directors I am a workshop presenter (slightly discounted rate available). FULL REGISTRATION: (Food and lodging <b>per person</b>)Full Registration(Required) FULL REGISTRATION Base Cost: (Food and lodging per person) NOTICE: REGISTRATION DEADLINE IS JULY 1, 2024.ROOM RESERVATION: (Rooms are Dormitory Style, common bathrooms on each floor)DOUBLE OCCUPANCY: Name of Roommate ROOM RESERVATIONROOM RESERVATION (Check all that apply) DOUBLE OCCUPANCY ADDITIONAL NIGHTS - Double (Sunday) ADDITIONAL NIGHTS - Double (Monday) SINGLE OCCUPANCY. ADDITIONAL $15/night X 2 nights ADDITIONAL NIGHTS - Single (Sunday) ADDITIONAL NIGHTS - Single (Monday) TOURS (Includes Sunday picnic; Monday lunch stop, private pay) Sunday Tour Monday Tour (Sunday Tour: Clemens and Munsinger Gardens, and picnic) (Monday Tour: Paddle wheel boat tour on St. Croix River) I would be interested in a Convention t-shirt. Yes No (Interest will determine availability and cost. N.B. IMO must receive email with interest by June 14th.)There are very few rooms with in-room baths. Please call Michelle for availability: 574-283-0279Special Considerations: I am a: vegan I am a: vegetarian I am: gluten intolerant I have physical limitations. Please Explain Explain: TOTAL COST FOR REGISTRATION SELECTIONS This page is unsecured. Do not enter a real credit card number! Use this field only for testing purposes. Payment Method(Required)PayPal CheckoutCredit Card American ExpressMasterCardVisaSupported Credit Cards: American Express, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Download
Beginning Experience