Registration Form for WIN Caucus
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Registration Form for
WIN Caucus
August 17-18, 2007
Woodstock Inn and Resort - Woodstock, Vermont
Please print this page, fill out the Registration Form, and Fax it to: 802 457-1501
OR Mail it to:
Woodstock Institute for Negotiation, Pomfret Stage Road-Drawer 29, Woodstock, Vermont 05091
Name: _____________________________________________ I go by (for Name Tag): __________________
Company/Organization: ________________________________________ Position: ____________________
Street Address: ______________________________________________________________________________
______________________________________________________________________________
City: _____________________________________________ State: _______________ ZIP: ______________
Work Phone: ____ ___________ Home Phone: ____ ___________ Fax: ____ ___________
E-Mail Address: ____________________________________________________________________
Fees:
___ WIN Caucus: August 17-18, 2007 $ 795.00 $_________
Includes Copy of Latest WIN Workbook
___ Set of WIN Reminder Cards with holder $ 25.00 $_________
___ Taking of the 2 Conflict Behavior Surveys $ 50.00 $_________
___ Late Fee if WIN receives payment after August 2, 2007 $ 50.00 $_________
Sub-Total $_________
Less Discounts:
___ Early Action - WIN must receive Payment by July 12, 2007 -$ 50.00 $_________
___ Multiple Employees Registering for same program -$ 50.00 $_________
___ Government/Non-Profit Full-Time Employee -$ 150.00 $_________
Total Amount Due $_________
Payment:
___ Payment Enclosed ___ Payment will be mailed
(Please make check Payable to "Woodstock Institute for Negotiation")
Please Charge to: __ VISA __ MasterCard __ American Express __ Diners Club
Card Number: _______________________________________ Expires: ___ _____
Name as it appears on card: _____________________________________________
Signature: ___________________________________
Policies of the Woodstock Institute for Negotiation for this Program:
Government/Non-Profit Employees: This discount of $150.00 is only available to full-time employees
of a 1) a state, county or local government entity; 2) a federal government entity; or 3) a Non-Profit organization
which qualifies under federal law as a 501(c)(3) tax-exempt charitable, educational or religious organization.
Multiple Employees: If multiple employees of the same company, organization, or state or federal agency
register for the same WIN Caucus, then each of the employees shall be entitled to a discount of $50.00.
Cancellation Policy: Up to 14 days prior to the WIN Caucus, you are allowed to cancel your registration
entitling you to a refund of your payment less a cancellation fee of $50.00. No refunds will be given after this
time, but you will be allowed to send a substitute person to the WIN Caucus you registered for OR you or your
substitute may attend a future WIN Caucus for a re-registration fee of $50.00.
If you are not able to print this Registration form, please send us an e-mail or call us and we will fax or mail
the Registration Form to you.
If you have any questions, please call us Toll Free at:
800 457-3211
July 3, 2007
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