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Photo courtesy John Winters Thanks to The Boren Foundation, and Jack and Karen Kay Leonard for making this website possible. |
2003 Indiana Lead-Safe and Healthy Homes Conference
October 15 & 16, 2003
Registration Form
Marriott East
7202 East 21st St.
Indianapolis, IN 46219
Conference Fees Exhibitors: · 8’x 10’ Booth: $250 before Sept. 26. $300 after Sept. 26. · 6’ Tabletop: $150 before Sept. 26. $200 after Sept. 26. Exhibitor includes conference registration for one person. Locations will be assigned on first-come, first served basis. Participants: · First person from organization: $125 before Sept. 26. After Sept. 26 the fee is $150. · Additional people from organization: $95 before Sept. 26. After Sept. 26 the fee is $125. · If you want to receive Risk Assessor or Lead Supervisor Refresher training as part of attending the conference, there is an additional fee of $95. Click here for more details Registration fee excludes hotel rooms. Call 317-352-1231 before September 26 to reserve a room for $79 for government and non-profit and $85 for others. |
We try to keep it simple. You can register by sending an email to Tom Neltner at mccabe@ikecoalition.org with the following information:
Name
Organization
Address
Phone
Fax
Email
Amount Due
Payment Method (check or credit card)
Whether you plan to take the refresher training.
Any Special Arrangements or Needs
You can also use print this page or download registration form in Word and:
Email completed form to Tom Neltner at mccabe@ikecoalition.org;
Fax it to him at 866-234-8505 or 317-248-4846; or
Mail it to him at:
Lead-Safe Indiana Task Force
5244 Carrollton Ave.
Indianapolis, IN 46220-3181
You can register more than one person with one email, but if you use the form, please use one page per person.
We accept checks or credit cards. It is best if payment is received before September 26. If we have to submit invoices after the conference, there is an additional $15 billing fee for each invoice sent.
If you are paying by check, please make check payable to "Lead-Safe Indiana Task Force" and mail it to 5244 Carrollton Ave., Indianapolis, IN 46220-3181.
If you are paying by credit card, only Visa and Mastercard are accepted. Please provide credit card number and expiration date. The Environmental Management Institute will process the payment on behalf of the Task Force.
Tom Neltner will confirm registrations by email within four business days of receipt. Please contact him at 317-442-3973 or mccabe@ikecoalition.org with any questions or concerns.
NAME ____________________________________________________
ORGANIZATION ____________________________________________
ADDRESS __________________________________________________
CITY_______________________________________________________
STATE, ZIP _________________________________________________
PHONE _____________________ FAX __________________________
E-MAIL ____________________________________________________
Are you planning to take the refresher training? __ If so, which one? ____ Risk Assessor ___ Lead Supervisor
Registration Fee $______ I will pay by ____ check _____ Visa ______ Mastercard.
If paying by credit card, my card # is ______________________________
and my card expiration date is __________________
If you need special arrangements to attend the conference, please contact Tom Neltner at 317-442-3973 or mccabe@ikecoalition.org by September 26 so arrangements can be made.