Registration
gistration
NAME ___________________________________________________________ COMPANY _____________________________________________ NAME FOR BADGE ________________________________________________________________________________________________________ EMAIL ________________________________________________________________ PHONE ___________________________________________ ADDRESS _______________________________________________________________________________________________________________ CITY _________________________________________________________ STATE _______________________ ZIP _________________________ SPOUSE/GUEST NAME FOR BADGE _________________________________________________________________________________________
EMERGENCY CONTACT NAME _______________________________________ EMERGENCY CONTACT PHONE ___________________________ REGISTRATION FEES (Full registration includes the Excom Meetings, Welcome Reception, Technical Sessions, Poster Sessions, Exhibits, and Lunch and Breaks on Saturday, Monday, and Tuesday)
EARLY BIRD (Through 8/17/18)
AIPG Member Full Registration Non-Member Full Registration
Young Professional Full Registration (must be AIPG YP Member) Daily Registration Sat Sun Mon Tues
Spouse/Guest Full Registration / or Welcome Reception Only
Student Full Registration / with Sat. Luncheon, 9/8/18 Student Career Workshop Student Daily Registration Sun Mon Tues
AIPG Luncheon Sat., 9/8/18, Free/Full Registration;$15/Students; $35/Non-Reg TOTAL AMOUNT DUE
FIELD TRIPS (must be registered for the conference)
Cripple Creek and Victor Mine Tour (Sat., 9/8/18, 8:00 am - 5:00 pm)
South Park Colorado-Geologic Framework (Sun., 9/9/18, 7:00 am - 6:00 pm)
Wall Mountain Tuff-Colorado Rockies (Sun., 9/9/18, 8:00 am - 4:00 pm)
Portland Quarry/Cement Plant;Florence Oil (Sun., 9/9/18, 8:00 am - 5:00 pm)
Garden of the Gods Geology (Sun., 9/9/18, 1:30 pm - 5:00 pm)
Arkansas Valley Geothermal (Mon., 9/10/18, 8:00 am - 5:00 pm)
Western Museum of Mining & Industry and
the US Air Force Academy Tours (Mon., 9/10/18, 9:30 am - 3:00 pm)
Colorado Springs Hazards/Landslides (Tues., 9/11/18, 8:00 am - 5:00 pm)
Olympic Training Center Tour (Tues., 9/11/18, 9:00 am - 12:00 noon)
Florissant Fossil Beds National Monument (Tues., 9/11/18, 1:00 pm - 5:00 pm)
TOTAL AMOUNT DUE $99 $99 $45 $45 $ $ $
$ $
Acceptance of Terms: I understand that by registering for the 2018 AIPG Confer- - which arise out of or result from my attendance at the AIPG National Conference, app, of me and/or my products, for conference related publicity (e.g., website, TPG,
Send completed form to: American Institute of Professional Geologists (AIPG) phone (303) 412-6205,
cld@aipg.org; Register online at
www.aipg.org.
PLEASE CHECK METHOD OF PAYMENT (Credit cards are processed in US dollar amounts only)
Card No._________________________________________________ Print name of cardholder ____________________________________
city, state, and zip) ________________________________________ ________________________________________________________
Hotel Information: be sure to use the group code ‘American Institute of Professional Geologists Annual be honored until 8/20/18.
Cancellation Policy: - funds can be issued for cancellations after August 24, 2018, or for no-shows after the
Map Source: Colorado Geological Survey, Colorado Springs Landslide SusceptibilityMap,El Paso County, Co. Quadrangle, 2003
www.aipg.org Jul.Aug.Sep 2018 • TPG 5
AMOUNT TOTAL $99
$ $99 $99 $99 $45 $99 $ $ $ $ $
$425 $475 $325 $250
$225 / $45 $145 / $160 $95
$0 / $15 / $35
REGISTRATION (After 8/17/2018)
$525 $575 $425 $350
$325/ $45
$ $ $ $ $
$145 / $160 $ $95
$0 / $15 / $35
$ $ $
AMOUNT TOTAL Welcome Reception (Sunday) (please check if attending, included with registration) AWG Workshop (Sat) Rockware Workshop (Sat)
AIPG Awards Banquet (Monday) Please select your dinner choice:
Make a Donation to the Foundation of the AIPG for the Student Career Workshop
TOTAL AMOUNT DUE TOTAL AMOUNT DUE (from all sections) $70 $ $
$ $
$ TOTAL
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