HOW TO REGISTER HOTEL RESERVATIONS Self-Help Counties Coalition is keeping with the “GOING GREEN” theme this year, so we are printing less materials and we ask that you register online. However, you can complete the form below and return to the contact information below. Due Wednesday, October 16, 2013 Register instantly Online: http://www.regonline.com/2013focusonthefuture Register by Mail: Self-Help Counties Coalition 1029 K St, Suite 26, Sacramento, CA 95814 Register by Fax: 916-914-2412 Register by Email: selfhelpcounties@gmail.com Phone: 916-514-9967 Name The Westin San Diego 1-888-627-9033 Ask for the 2013 Focus on the Future/Self-Help Counties Coalition rate of $189 per night for single occupancy/$209 double occupancy. Government rates also available. Note all reservations booked under the government rate must show Government ID at check-in to keep the special rate. Title Organization Address City Phone Email Credit Card Information (We do not accept American Express) Visa MasterCard State Card Number Zip Expiration Date Name on Card Billing Address (if different from above) Signature REGISTRATION FEES (Please copy this form and fill out separately for each attendee.) QR Code to Register Online # of Attendees Early Bird Registration Fee: Regular Registration Fee: Golf Tournament: Goods Movement Tour: ICM Tour: Trolley Renewal Tour: San Diego Waterfront Tour: Gaslamp Walking Tour: $550.00 per person (by October 18) $625.00 per person (after October 18) $180.00 per person $25.00 per person (Limited to 40 people) $25.00 per person (Limited to 40 people) $25.00 per person (Limited to 25 people) $25.00 per person (Limited to 30 people) $25.00 per person (Limited to 30 people) Total $ Make Checks Payable To: Focus on the Future 2013/Self-Help Counties Please make sure to include the registration form, for each registrant, when submitting payment by check for the total amount. This will help Self-Help Counties keep proper records. If paying by credit card, please provide the matching credit card billing address and exact name on credit card. No refunds after Friday, October 18. All cancellations must be in writing. Substitutions are always accepted. Conference *The Monday Evening Fundraising Event is included in your registration fee and part of the fee registration includes most events that begin on the will go towards the effort. Additional information will be provided for guests and sponsorships. evening of November 17 and end on November 19, *Caltrans Employees, please contact Jenny Devine directly at jmdevinegroup@gmail.com to register at the special Caltrans rate. conference materials and transportation to and from the offsite tours. There are no daily rates.