Registration is required of ALL attendees. While a limited number of on-site registrations can be accepted, we urge you to register below now to reserve your place at the 2013 Symposium.

Name : Position : Affiliation : Address : City : State : Zip : Email Address : Phone : Fax :

Reduced Registration Fees for Sponsors

My organization is interested in being a Symposium Sponsor at the following level:

Gold Level Sponsor ($7,500) -- 2 Complementary Registrations
Silver Level Sponsor ($5,000) -- 1 Complementary Registration
Bronze Level Sponsor ($2,500) -- 2 Registrations at half price

Other Registration Categories and Applicable Fees.

Select your participation category as applicable.

Regular Registration -- Received after July 17, 2013 ($975/participant)
Government or Tribal Representative ($375/participant)
Non Profit or Conservation Organization ($375/participant)
Current Member Company* ($425/participant)
Current Affiliate Firm** ($425/participant)
University Faculty ($375/participant)
University Student ($100/participant)
GW Community Only - September 30 Keynote Address (No Cost)
GW Community Only - October 1 Opening Address (No Cost)
GW Community Only - October 1 Closing Address (No Cost)

Payment

Payment may be made by Credit Card, Electronic Funds Transfer or Check.

Method

Please select your payment method.

Credit Card
Electronic Funds Transfer
Check

Credit Card information may be entered below. If you choose to pay by Electronic Funds Transfer or Check, upon receipt of your Registration Form, we will be in contact with you with specific instructions.

Credit Card Type:

Visa Mastercard American Express

Cardholder Name:
Card Number:
Expiration Date:
Security Code:

Notes:

This is not a secure form. If preferred, credit card information may be faxed to us at 202-628-6825.

* This registration fee corresponds to industrial companies that are current members of the Ad-Hoc Industry Natural Resource Management Group.

** This registration fee corresponds to law firms and consulting firms that are current Affiliates of the Ad-Hoc Industry Natural Resource Management Group.

We reserve the right to limit participation in order preserve audience balance among stakeholder groups and specific entities within those groups. If we are not able to confirm your registration, we will contact you. We appreciate your cooperation.

A reduced fee or fee waiver may be available in limited circumstances upon request.

Cancellations received after September 15, 2013 cannot be refunded.