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for 2011 Conference (October 10, 11, 12)

* = Required
Name*
Title
Company
Address*
City*
State*
Zip*
Phone*
Email
(required for receipt)
Conference Registration Options

Preconference Only
$70

Conference Only
$199 Chapter Members and Affiliates
$249 Others

Conference AND PreConference
$269 Chapter Members and Affiliates
$375 Others

Conference Only - Students
$110

Conference AND Preconference - Students
$180

Fee for Academic Credit
(In addition to the full conference price. This includes $55 PSU fee and $25 ASTD admin fee)

$75

Additional Conference Registration Information

Demographic Information
Completing the information below will assist the Chapter in building marketing materials for future events. This information is not identifiable to any person and will only be summarized for the entire conference. Completing or not completing this information will not affect your registration.
Industry
Agriculture
Select only ONE.
Banking, Finance, Insurance
 
Business Services
Communication
Education / Government
Healthcare
Hospitality / Tourism
Manufacturing / Construction
Nonprofit
Services (consulting, specialty firms)
Technology
Utilities
Other (please list)

Professional Role
Academician
Select only ONE.
Training Coordinator
 
Training Specialist
Training Manager / Director
Technical Trainer
HR Specialist
HR Manager
Independent Consultant
Internal Consultant
OD Specialist or Manager
Other (please list)

Years in the T&D Field
0 - 2 Years
Select only ONE.
2 - 5 Years
5 - 10 Years
10 or more

Enter Chapter Member Number
Discounted amounts are for Chapter Members / Local Affiliates / Regional Chapters only. National ASTD membership does not confer a discount. If you are from a local affiliate or regional chapter, you will need to secure the special code from your organization in order to automatically receive the discounted amount. Please email the ASTD office if you do not have your Chapter membership number.

To receive the Chapter member discount, enter your Chapter member number here:

Enter Promotional Code
If you have received a promotional code from the ASTD office, enter it below. Your total discounted amount will appear on the confirmation page.

Enter promotional code here:

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