Speaker Registration Form



USRBC Annual Meeting 2011
October 3-5, 2011
The Art Institute of Chicago and the Swissotel
Chicago, IL

REGISTRATION FORM

 
 
1.

Please enter the information indicated below.
First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
Address 3:
City:
State/Province
(US/Canada):
Postal Code:
Country:

2.

Registration Level A: 
USRBC ANNUAL MEETING (ALL OCTOBER 3-5 EVENTS, INCLUDING THE GALA DINNER)

Please choose the fee amount based on your USRBC membership status.  


Please help us with our planning by telling us which meals listed below you will attend.

 

 
USRBC Members - $995
Non-Members - $1695
I plan to attend the Gala Dinner on Monday, October 3
I plan to attend the Luncheon on Tuesday, October 4
I plan to attend the Cocktail Reception on Tuesday, October 4
3.

Registration Level B:
USRBC GALA DINNER ONLY

 
USRBC Members - $400
Non-Members - $750
4.

Please select your payment method:
CHECK -- Please make checks payable to the: U.S.-Russia Business Council, 1110 Vermont Avenue, NW, Suite 350 Washington, DC 20005
WIRE TRANSFER -- U.S.-Russia Business Council, Bank of America, 1801 K Street, NW, Washington, DC 20006. ABA Routing # 026009593, Account # 001923952069
CREDIT CARD -- Please specify your credit card type, number, card holder name, and expiration date in the Comment box below.
  • Comment:

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Payment policy: 
Please note that the U.S.-Russia Business Council must receive your check or wire transfer payment no later than September 27, 2011. Only credit card payments will be accepted after September 27, 2011.  

Cancellation and Refund Policy:
Since the U.S.-Russia Business Council is required to guarantee payment for all events associated with the Annual Meeting, registration fees are non-refundable after September 24, 2011.  Registration is transferable with notification.    

Please contact Jo Bottalico at (202) 739-9188 or bottalico@usrbc.org if you have questions about your registration fee payment.
 
5.

Please include any additional comments.
 

  • 202 characters left.

Thank you for completing your Annual Meeting registration form. We look forward to seeing you in Chicago!