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Participant
Registration Form
- Fill
in the names below for each person from your community/county whom
you are registering to attend the event.
- Name and Company Name should read as you want them to appear on the name
badge(s).
- Please provide an email address for each individual
for further communication.
-
Elected
Public Officials - please list your title with your name.
- Your $40
registration fee covers the entire Great Northwest event. There are no
price differences if you only choose to attend some of the activities.
- If you register
and don't cancel by February 1, you will be invoiced the $40 fee.
Likewise, if you have paid and don't cancel by February 1, there will be
no refund.
All participants must submit
$40 per person by Friday, January 25, 2008 to:
Great Northwest Day at the Capitol
c/o Deb Powers, Director of Healthy Communities
Heartland Foundation
518 S. 6th Street,
St. Joseph, MO 64501
Call Deb at 800.447.1083 or 816.271.7200 with any questions.
*************
Make checks payable to Heartland Foundation, note: Great Northwest Day at the
Capitol.
Heartland Foundation can now accept credit cards for payment: VISA and MasterCard.
If you wish to pay by credit card, please call us after you submit your
participant list above with
your credit card number, type of card, name on card, card billing address,
and expiration date.
*************
Note:
Sponsors receive two complimentary
registrations to the event.
Those individuals do need to register using the form above in order to have
a name badge prepared.
Transportation to the event should be arranged locally.
A block of
45 rooms has been reserved for Monday night, February 4, 2008,
and 110 rooms reserved for Tuesday night, February 5, 2008.
Participants must call the Capitol Plaza (host hotel) for their own rooms.
The group rate is $94 per night, single/double. Suites are available for
$122-131 a night.
Capitol Plaza: 1-800-338-8088
This block of rooms will be held until
01/05/08, after which any unreserved rooms
will be released and made available for sale to the general public.
There is no guarantee that the above quoted group rates will be available after the cut-off date.
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