Genzyme Center - PIUG
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Registration Type PIUG 2014 Biotechnology Meeting Tuesday, February 25, 2014 Genzyme Center 500 Kendall Street Cambridge, MA 02142 Boston Marriott Cambridge Two Cambridge Center Cambridge, MA 02142 Call 800-288-9290 617-494-6600 Please mention PIUG 2014 Biotech Meeting Accommodations when you call for reservation. Reduced Hotel Rates are guaranteed until Friday, February 10th, 2014 CONFERENCE REGISTRATION FORM Before After After January 22nd 2014 January 21st to February 17, 2014 February 17th, 2014 On Site Amount Member: Non-Member: Student: Retiree: Unemployed: Rates Rates Rates $95.00 $150.00 $225.00 $190.00 $250.00 $325.00 $50.00 $75.00 $95.00 $50.00 $75.00 $95.00 $50.00 $75.00 $95.00 This is my first time attending a PIUG Conference Yes No Total: Special Physical or Dietary Needs. If yes, check: If so, please tell us your special needs: _______________________ May PIUG use your photo in a Piug Newsletter? Yes No Please tell us, if you are a: Sponsor Sponsorship Complimentary Attendee Speaker PAYMENT INFORMATION Please type or carefully print the information requested exactly as it should appear on the roster and participant's name badge. If the participant uses a nickname, please indicate how it should appear on the name badge. Check Visa MasterCard American Express Discover Name: Employer/Affiliate of: Home Address: Home City Zip: Work Phone: W ork Fax: E-mail: CARD HOLDERS INFORMATION First Name: Last Name: Billing Address: City, State, Zip: Zip: Credit Card Number: Exp. Date: Sec Code (CVV): Signature of Card Holder: OUR CURRENT REFUND POLICY If cancellation is received prior to February 1st, 2014, a full refund will be provided minus a 10% administration fee. No refunds will be provided after February 1st, 2014. Any cancellation must be sent in writing to Ken Koubek at [email protected]. Print this form, attach payment and submit to: Patent Information Users Group, Inc. 40 E. Main Street, #1438 Newark, DE 19711 Phone: (302) 660-3275 Fax: (302) 660-3276 http://www.piug.org/
Transcript of Genzyme Center - PIUG
Registration Type
PIUG 2014 Biotechnology Meeting Tuesday, February 25, 2014
Genzyme Center 500 Kendall Street
Cambridge, MA 02142
Boston Marriott Cambridge Two Cambridge Center Cambridge, MA 02142
Call 800-288-9290
617-494-6600 Please mention PIUG 2014 Biotech Meeting Accommodations
when you call for reservation. Reduced Hotel Rates are guaranteed until Friday, February 10th, 2014
CONFERENCE REGISTRATION FORM Before After After
January 22nd 2014 January 21st to February 17, 2014
February 17th, 2014 On Site Amount
Member:
Non-Member:
Student:
Retiree:
Unemployed:
Rates Rates Rates
$95.00 $150.00 $225.00
$190.00 $250.00 $325.00
$50.00 $75.00 $95.00
$50.00 $75.00 $95.00
$50.00 $75.00 $95.00
This is my first time attending a PIUG Conference Yes No Total:
Special Physical or Dietary Needs. If yes, check:
If so, please tell us your special needs: _______________________
May PIUG use your photo in a Piug Newsletter? Yes No
Please tell us, if you are a: Sponsor Sponsorship Complimentary Attendee Speaker
PAYMENT INFORMATION
Please type or carefully print the information requested exactly as it should appear on the roster and participant's name badge. If the participant uses a nickname, please indicate how it should appear on the name badge.
Check Visa MasterCard American Express Discover
Name:
Employer/Affiliate of:
Home Address:
Home City Zip:
Work Phone: Work Fax:
E-mail: CARD HOLDERS INFORMATION
First Name: Last Name:
Billing Address:
City, State, Zip: Zip:
Credit Card Number: Exp. Date: Sec Code (CVV):
Signature of Card Holder:
OUR CURRENT REFUND POLICY
If cancellation is received prior to February 1st, 2014, a full refund will be provided minus a 10% administration fee. No refunds will be provided after February 1st, 2014. Any cancellation must be sent in writing to Ken Koubek at [email protected].
Print this form, attach payment and submit to:
Patent Information Users Group, Inc.
40 E. Main Street, #1438
Newark, DE 19711
Phone: (302) 660-3275
Fax: (302) 660-3276
http://www.piug.org/
