Registration Form for
Certificate Program for Negotiating, Collaborating
and Leading in Today's World

October 26-28 and November 15-16, 2011
Shepard's Pie by the Gorge, U.S. Route 4, Quechee, Vermont

Please print this 2-page form, fill out the Registration Form and 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:

___ October 26-28 and November 15-16, 2011 - Post Irene Reduced Rate      $ 1,395.00  $_________

      
___ Completion of Certificate Program ($225.00 if paid later)             $   195.00  $_________  

___ Late Fee if WIN receives payment after October 24, 2011               $   100.00  $_________

    Sub-Total                                                                        $__________


Less Discounts:

  
___ Multiple Employees Registering for same program                      -$  50.00    $_________

___ Government & Non-Profit Full-Time Employee                           -$ 300.00    $_________

___ Repeating Entire Program                                             -$ 300.00    $_________

    Total Amount Due                                                                 $__________

Payment:

___ Payment Enclosed    ___ I wish to pay over time -- 10% due now 

        (Please make check Payable to "Woodstock Institute for Negotiation")


Policies of the Woodstock Institute for Negotiation for this Program:

Government/Non-Profit Employees: This discount of $300.00 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 all five days of the same training program, then each of the employees shall be entitled to a discount of $50.00.

Payment over Time: Participants may elect to pay the fees for this program over time by ten equal monthly payments.  Each payment will be equal to ten percent of the total fees with the first payment due at the time of registration and each subsequent payment due on the 1st of the month beginning on December 1, 2011 and ending on August 1, 2012.  There is no interest charged for this election provided all payments are received by the Woodstock Institute for Negotiation within 30 days of each due date.  In the event any payment is not received within 30 days of a due date, interest will be charged on the outstanding balance at the rate of 1% per month (ANNUAL PERCENTAGE RATE = TWELVE PERCENT (12%) PER ANNUM)

Hotel Accommodations: Hotel accommodations are NOT included with your registration fee.  You must make your own reservations.

Cancellation Policy: Up to 14 days prior to the beginning of the first session, 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 program you registered for OR you or your substitute may attend a future Certificate Program for Negotiating, Collaborating and Leading in Today's World for a re-registration fee of $100.00.  If you attend the first session and are unable to attend the second session, you may attend a future second session of the Certificate Program for Negotiating, Collaborating and Leading in Today's World 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

September 1, 2011

 

Woodstock Institute for Negotiation
Pomfret Stage Rd - Drawer 29
Woodstock, Vermont  05091-0029
United States of America
Toll Free in USA & Canada:  800-457-3211
Telephone:  802-457-3211
Fax:  802-457-1501
www.woodstockinstitute.com
e-mail address:  BobODonnell@woodstockinstitute.com