This worksheet is a useful tool for individuals who are responsible for registering others for the CASE DIII Conference. This is not a registration form and cannot be submitted in lieu of registering online. Visit casethree.org for information and to register. The final registration deadline is Feb. 6, 2015. Name (name of person attending conference) Preferred name on badge Email Institution CASE Online Password (you will need this to register online) Title Mailing Address City, State, Zip Office Telephone Mobile Telephone Emergency Contact Name & Phone Number CFRE ☐ Yes ☐No Select Your Registration Option All rates are in USD, unless specified. Customers outside of the United States will see a converted amount during the registration process, based on their location in either CAD, GBP, EUR, AUD, SGD or USD. By Nov. 17, 2014 ☐ CASE Member - $359 (includes Monday Special Event, Tuesday Awards Banquet and Wednesday Closing Brunch) ☐ CASE Nonmember - $459 (includes Monday Special Event, Tuesday Awards Banquet and Wednesday Closing Brunch) ☐ Group Registration - $349 (To qualify for a group discount, 3 or more registrants must be from the same institution and registering at the same time, group registration deadline Jan 9, 2015) ☐ Newcomers Workshop - $199 (includes lunch) ☐ Art of the Ask Immersion Session - $149 (includes lunch) ☐ HBCU Community of Practice - $149 (includes lunch) After Nov. 17, 2014 ☐ CASE Member - $459 (includes Monday Special Event, Tuesday Awards Banquet and Wednesday Closing Brunch) ☐ CASE Nonmember - $549 (includes Monday Special Event, Tuesday Awards Banquet and Wednesday Closing Brunch) ☐ Group Registration - $349 (3 or more, registered at the same time, group registration deadline Jan 9, 2015) ☐ Newcomers Workshop - $249 (includes lunch) ☐ Art of the Ask Immersion Session - $199 (includes lunch) ☐ HBCU Community of Practice - $199 (includes lunch) Full Conference Included Events If you are registering for the full conference, the Monday Night Special Event, Awards Banquet and Closing Brunch are included in the registration fee. To assist the planning committee, please let us know if you will attend those events. ☐ Yes, I will attend the Monday Night Special Event. ☐ Yes, I will attend the Awards Banquet. ☐ Yes, I will attend the Closing Brunch. Single-Day Registrations ☐ CASE Member - $229 (does NOT include Monday Special Event or Tuesday Awards Banquet) ☐ CASE Nonmember - $279 (does NOT include Monday Special Event or Tuesday Awards Banquet) Optional Events ☐ Presidents Day Luncheon - $45 ☐ Opportunity & Inclusion Luncheon - $45 ☐ Monday Special Event - $50 (for guests and single-day registrants) ☐ Tuesday Awards Banquet - $75 (for guests and single-day registrants) Select Your Area of Greatest Interest ☐ Advancement Services ☐ Alumni Relations ☐ Fundraising/Development ☐ Communications/Marketing ☐ Philanthropy ☐ Independent Schools ☐ Community/Technical College Choose Your Institution Type ☐ Four-year Public ☐ Four-year Private ☐ Independent School ☐ Community/Technical College How Many Years Have You Worked in Advancement? ☐0-4 ☐ I am new to advancement. ☐ 5 -14 ☐ I have less than four years in advancement and would like a mentor ☐ 15 - 24 ☐ This is my first CASE conference ☐ 25 + Conference Volunteers ☐ I would like to volunteer at CASE concierge ☐ I would like to be a conference host. ☐ I would like to be a mentor. ☐ I would like to be a moderator. ☐ I would like to assist with registration. ☐ I would like to donate an auction item listed below. Please list any dietary restrictions or provide any special assistance you may need. Cancellation/Refund Policy CASE District III Cancellation/Refund Policy While we do not believe you would want to miss the conference, we strictly adhere to the following cancellation policy. Registration fees for cancellations received, on or before 5 p.m. EST Jan. 9, 2015 will be refunded, less a $50 handling fee. Conference fees will not be refunded for cancellations received after 5 p.m. EST on Jan. 9, 2015 or due to inclement weather. Requests for a refund after Jan. 9, 2015 must be submitted online via the Cancellation/Refund Request Form. Requests will be processed after Apr 30, 2015. Questions? States: MS, NC, SC, KY, VA Tanea Pettis, Registration Co-chair UNC General Alumni Association Email: tanea_pettis@unc.edu Office: (919) 843-9694 AL, FL, GA, TN Amanda L. Trabue, Registration Co-chair Vanderbilt University, Peabody College Email: amanda.trabue@vanderbilt.edu Office: (615) 936-4533
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