APCA 2008 Membership
and Fall Conference Registration

Coralville, IA

School Name:

_________________________________

 School Advisor:

_________________________________

School Address:

_________________________________

City:

_________________________________

State:

__________________    Zip: ______________

Phone:

___________________  Fax: ______________

 Email:

_________________________________

Student Population

Demographics

   __ BELOW 3,000

Public:__  Private:__  Religious Affiliated:____

   __ 3,000 – 5000

Commuter: __

   __ 5,000 - 10,000

4-year: __ 2-year: __

   __ 10,000 -15,000

Tech/Trade: __

   __ 15,000 - UP

Activities Budget: $ __________

% of Budget spent on:

Comedy: ____%

Lectures: ____%

Movies: ____%

 

Music: ____%

Novelties: ____%

Other: ____%

Names of Delegates Attending APCA Fall Programming Conference
(list additional delegates separately):

Delegate   1 _______________________

Delegate   9 _______________________

Delegate   2 _______________________

Delegate   10 _______________________

Delegate   3 _______________________

Delegate   11 _______________________

Delegate   4 _______________________

Delegate   12 _______________________

Delegate   5 _______________________

Delegate   13 _______________________

Delegate   6 _______________________

Delegate   14 _______________________

Delegate   7 _______________________

Delegate   15 _______________________

Delegate   8 _______________________

Delegate   16 _______________________

All schools registering delegates must be APCA members in good standing or pay non member prices.
REGISTER EARLY AND SAVE BIG!!

Coralville Conference Pricing

Prior to 10/10/08

Member

Non-Member

Member Day Pass

Non-Member Day Pass

1-5 delegates

$159 / delegate

$199 / delegate

$89 / delegate

$109 / delegate

6+ delegates

$139 / delegate

15% discount

$89 / delegate

$109 / delegate

After 10/10/08

Member

Non-Member

Member Day Pass

Non-Member Day Pass

1-5 delegates

$179 / delegate

$219 / delegate

$89 / delegate

$109 / delegate

6+ delegates

$159 / delegate

$199 / delegate

$89 / delegate

$109 / delegate

Spousal Fee

$129

 

 

 

__ Campus membership fees enclosed ($199 annually) - number of memberships:_____
     ___ I am already a member in good standing
Schools registering delegates must be APCA members in good standing or pay nonmember prices.

$_________

Total # of Shirts:______
Indicate # per size: ____ Med   ____ Lg  ____ XL  ____ XXL   ____ XXXL

$_________

TOTAL FEES ENCLOSED or AUTHORIZED TO BE CHARGED
The APCA FEI Number is 650551461

$_________

# Vegetarian Meals:____    # Vegan Meals:___    #Kosher Meals:___
# Non Dairy Meals:____

Credit Card Orders:
__VISA   __MasterCard  __American Express
Card Number: ________________   Exp. Date: ________
Name on Card: ________________________
CVV2#: ______ (3 digit # on right back or card)
 
Signature: __________________________________ Date:___/___/___

Billing Information:
Billing Address:______________________________
City, State: _________________, _________ Zip: _____________

Faculty Advisor    ______________________________                        Date ____________________

Delegation Leader / Co-Op Buyer ________________________________
 

Coralville, IA Travel & Lodging Information:
November 10-12 2008
Theme: Popping with Programming
Coralville Marriott Hotel & Conference Center
300 East 9th Street, Coralville, IA52241
Reservations: (319) 688-4000

Rates: Rooms at the Coralville Marriott are $109 + tax flat rate up to 4 per night, parking is $8.00 per day.

Hotel Reservation Deadline: October 20, 2008 or until the block sells out. After that, all reservations taken will be based on a space and rate available basis, the room prices may go up substantially.  Reservations for the rooms at the Marriott are the responsibility of the school.

Airport & Shuttle Information: The nearest airport is Cedar Rapids (CID) 20 miles away, and estimated taxi fare is $30 one way.

DO NOT SEND MONEY TO APCA!

 

Delegate fees are non-refundable, but a $75 credit per canceled delegate goes towards next conference is allowable in event of cancellations toward any APCA conference to be held during the next one year time period.

The Fax to (865) 908-7104 or mail to: APCA - PO Box 4340 - Sevierville, TN 37862
Questions???? Call (800) 681-5031 or visit www.apca.com