PRINT NOV. 2009 CONFERENCE REGISTRATION FORM

Five ways to register:

Phone: 781-449-4010 ext. 101
Fax: 781-449-4024
Email: registration@learningandthebrain.com
Mail: PIRI, 35 Highland Circle, First Floor Needham, MA 02494-3099
Online: www.LearningAndTheBrain.com

PLEASE PHOTOCOPY THIS FORM FOR EACH APPLICANT.

If you experience problems printing this form, download the pdf version here.
Name
Position
Organization
Address
City Zip
Phone
Fax
Email

Demand is high and space is limited. Please register early to assure yourself a place.

Please register me for the conference.

Conference Registration for Nov. 20-22, 2009


General Registration: THROUGH Nov. 6, 2009

$535 Conference General Registration

$495 Conference Registration for Society Members


$

Late Conference Registration: AFTER Nov. 6, 2009:

Late Registration: $550 per person.

Late Registration for L&B Society members: $525 per person

 $

GROUP RATES- $475 per person.

General Group Rate: $475 per person

Five or more from one organization.

Registrations must be sent in together.		 $

DUAL CONFERENCE RATES- $475 per conference.

Register for Nov. and another conference and save. Discount ends on Nov. 6, 2009.
Please register me for the Nov. conference and the following:
____ San Francisco Conference on Feb. 18-20, 2010    ____ Washington DC Conference on May 6-8, 2010		 $
Please register me for a Pre-Conference Workshop on Friday, Nov. 20.
Add $25 if not attending the conference.
(Please indicate which one)

1. Best Learning Strategies in Your Classroom
9:00 a.m. - 1:00 p.m. ($185 per person)

 $

2. Memory Strategies
9:00 a.m. - 1:00 p.m. ($185 per person)

 $

3. Teaching the Teen Brain in the Modern Age
9:00 a.m. - 12:15 p.m. ($185 per person)

 $

4. Smart but Scattered: Executive Skills
9:00 a.m. - 1:00 p.m. ($185 per person)

 $
5. Introduction to the Brain and Neuroscience
9:00 a.m. - 1:00 p.m. ($185 per person)		 $
6. ADHD-Related Executive Functions and Complications Note: This workshop is full
9:00 a.m. - 1:00 p.m. ($185 per person)		 N/A
Special Events/Luncheons

_____Please register me for the "Meeting of the Minds" reception. (Free. Saturday, Nov. 20, at 5:45-6:45 p.m. at the Marriott Cambridge Hotel.) 		$

_____Please register me for the Networking Luncheons. ($29.50 per person. Sunday, Nov. 22, at 12:15-1:15 p.m. at the MIT Faculty Club.)  		$
_____Please check here if you would like professional development credits. ($5 charge for paper certificate copy for postage/shipping/handling). FREE if certificate is sent electronically. Please send ___By mail ($5) ___By email $

_____Please check here if you would like to earn graduate credits from Boston University. ($1,295 charge for Boston University tuition and administrative fee)		 $

_____Please check here if you plan to submit a poster session for the Nov. conference.

_____Please check here if you have attended the Learning & the Brain conferences before.

How did you hear about the conference? ______________________________________________________________________
  TOTAL: $


_____Please check here if you have any special ADA requirements, and call 781-449-4010 ext. 101.

The Boston Marriott Cambridge Hotel and MIT Faculty Club Hotel are ADA compliant.
Choose your method of payment (check one)
_____Check enclosed _____Purchase order enclosed
Make check or purchase order payable to Public Information Resources, Inc., and mail it along with your registration form to: Learning & the Brain, Public Information Resources, Inc., 35 Highland Circle, First Floor Needham, MA 02494-3099. P.O.s will be invoiced if sent without check. Registrations without payment or purchase order will not be confirmed.

_____Charge registration(s) to my credit card: ______VISA ______MasterCard _______AmEx
Card Number:
Exp. Date:
Cardholder Name:
Cardholder Billing Address/Zip:
Cardholder Signature:

REGISTRATION POLICIES

Registrations are taken and confirmed, on a first-come, first-served basis according to receipt of full payment or purchase order. Unpaid registrations without a purchase order will be cancelled after 30 days. If you do not receive a confirmation within three weeks after sending full payment or purchase order, call 781-449-4010. Earlt bird registraion is $475 per person and $440 per person for Learning & the Brain Society Members through August 15, 2009.  Registration is $535 per person and $500 for Learning & the Brain Society Members after August 15, 2009  and through Nov. 6., 2009 After Nov. 6, 2009, late registration is $550 per person or $515 for Society members. A $35 administrative fee will be added for on-site registration at the conference. Groups of five or more may register at $450 per person by August 15, 2009 and $475 after August 15, 2009 if registering together by with payment or purchase order.

 

SUBSTITUTIONS, CANCELLATIONS AND WAIT LIST

Substitutions are permissible up to seven days before the conference, but you must notify PIRI in writing by fax or mail. Cancellations must be requested no later than Nov. 6, 2009. No cancellations will be accepted after Nov. 6, 2009. Because cancellations incur substantial administrative costs, we regret that it is necessary to charge a cancellation fee of $150 per person. Registrants who cancel (through Nov. 6, 2009) in time to receive a refund will nonetheless incur a $150 processing fee. Cancellations must be sent in writing to PIRI at 35 Highland Circle, First Floor Needham, MA 02494-3099. or faxed to PIRI at 781-449-4024.

CONFERENCE PROGRAM CHANGES

Public Information Resources, Inc. (PIRI) reserves the right, without having to refund any monies to participants, to make changes in the conference, its program, schedule, location, and/or faculty should PIRI, in its sole discretion, deem any such changes necessary or advisable. Similarly, PIRI further reserves the right to cancel any sessions, events, workshops, credit courses, or the conference, entirely, in which case PIRI's liability to participants shall be strictly limited to a refund of those fees.

 
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