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Photo courtesy John Winters Thanks to The Boren Foundation, and Jack and Karen Kay Leonard for making this website possible. |
2006 Indiana Lead-Safe and Healthy Homes Conference
October 24 & 25, 2006
Registration Form
Marten House
1801 W. 86th St.
Indianapolis, IN 46260
Conference Fees Exhibitors: · 8’x 10’ Booth: $250 before
Sept. 15. $300 after Sept. 15 · 6’ Tabletop:
$150 before Sept 15. $200 after
Sept 15. 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 15.
After Sept 15, the fee is $150. · Additional
people from organization: $95 before Sept 15. After
Sept 15, the fee is $125. Registration fee excludes hotel rooms. Call 800-736-5634 or 317-872-4111 before Sept. 15 to reserve a room for $79. |
We try to keep it simple. You can register by sending an email to Janet McCabe at mccabe@ikecoalition.org with the following information:
Name
Organization
Address
Phone
Fax
Email
Amount Due
Payment Method (check or credit card)
Any Special Arrangements or Needs
You can also use print this page or download registration form in Word and:
Email completed form to Janet McCabe at mccabe@ikecoalition.org;
Fax it to her at 866-234-8505; or
Mail it to her at:
Lead-Safe Indiana Task Force
1201 N. Central Avenue #9
Indianapolis, IN 46202
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 15. 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
1201 N. Central Ave., #9 Indianapolis, IN 46202.
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.
Janet McCabe will confirm registrations by email within four business days of receipt. Please contact her at 317-902-3610 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 Janet McCabe at 317-902-3610 or mccabe@ikecoalition.org by September 15 so arrangements can be made.