SHINE 2011 Online Registration

Note that you will need to print and fax/mail the payment form that will be displayed after you submit your information.


Please enter the registration information below The registration deadline is 11:59pm Central Time on June 9th, 2011.
First Name:
Middle Name:
Last Name:
Affiliation
Address
Phone	Fax:
Email:
I am a Student:
If yes, are you applying for financial support?
Students applying for financial support are required to fill an additional form available in the "Important Links" menu.
	Registering for (Check all that apply¹):
Myself	Accompanying Guest(s)

1 Please note that regular registration fees cover the cost of conference rooms, equipment, poster boards and registration packets plus food and beverage that includes the daily breakfasts, coffee and snacks at breaks, reception food at the poster sessions (M, T, TH), and the banquet dinner. All accompanying persons who eat any meals or breaks must be registered and will receive badges that must be worn at meals.

Registration Fees

Check all appropriate boxes:

Regular:

Regular Participant

$390 (waived for SHINE students)

Accompanying Guest(s)

No. x

$150

Children over 5

No. x

$50

* $50 will be added for a late registration (starting June 10th, 2011)
Registration is free for Children under 5 y.o.

If you prefer to pay by check please mail registration form with check to:
Umbe Cantú
OlivEvents
2515 Coopers Post Ln.
Sugar Land, TX 77478

Banquet Attendance

Total number of Guests (including yourself) to attend the banquet

How many are Vegetarian?

Total number of Guests under 14

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