AACC Annual Convention
April 21-24, 2012
Registration Form
_______________________________________________________________________________________________________________________________________________________
First Name Middle Initial Last Name Nickname for Badge (not Dr., Ms., or full name)
_______________________________________________________________________________________________________________________________________________________
Job Title College/Organization
_______________________________________________________________________________________________________________________________________________________
Street Address City State/Country (other than U.S.) Zip/Mail Code
_______________________________________________________________________________________________________________________________________________________
Phone Fax Email (Must be attendee’s email address.)
Do you have a disability that requires special accommodations? Yes* o No o Do you have dietary restrictions? Yes* o No o If yes, AACC will contact you.
o Member Package $735
(Early bird before Jan. 23)
•;Convention;Registration
•;Access;to;Exhibit;Hall;&;Events
•;Hail;&;Farewell;Luncheon
•;Gala;Reception;&;Dinner
•;Tuesday;Brunch
o Nonmember Package $785
(Early bird before Jan. 23)
•;Convention;Registration
•;Access;to;Exhibit;Hall;&;Events
•;Hail;&;Farewell;Luncheon
•;Gala;Reception;&;Dinner
•;Tuesday;Brunch
o Standard Package $835
(After Jan. 23)
•;Convention;Registration
•;Access;to;Exhibit;Hall;&;Events
•;Hail;&;Farewell;Luncheon
•;Gala;Reception;&;Dinner
•;Tuesday;Brunch
Onsite $835-no meals
(After March 23)
Registration Rates
Spouse/Guest Information
____________________________________________________________________________
First Name Middle Initial Last Name
____________________________________________________________________________
Nickname for Badge (not Dr., Ms., or full name)
Complete;only;if;paying;Spouse/Guest;Registration;Fee.;Only;registered;spouses/
guests;receive;a;badge,;program;book,;and;other;materials.
Emergency Contact (Required)
____________________________________________________________________________
First Name Last Name
____________________________________________________________________________
Address
____________________________________________________________________________
Phone Relationship
Payment
Check;enclosed;(Payable;to;AACC)
Check;#______________________________
Credit Card:
o Visa o MasterCard o;Am;Ex
Ticketed Events (Tickets are not usually available on site.)
#;tickets
$50;x;______
$95;x;______
$25;x;______
$45;x;______
o Member Base $650
(Early bird before Jan. 23)
•;Convention;Registration
•;Access;to;Exhibit;Hall;&;Events
•;Hail;&;Farewell;Luncheon
o Nonmember Base $700
(Early bird before Jan. 23)
•;Convention;Registration
•;Access;to;Exhibit;Hall;&;Events
•;Hail;&;Farewell;Luncheon
o Standard Base $750
(After Jan. 23)
•;Convention;Registration
•;Access;to;Exhibit;Hall;&;Events
•;Hail;&;Farewell;Luncheon
o Spouse/Guest $300
(Early bird before Jan. 23)
(After Jan. 23 $350)
•;Convention;Registration
•;Access;to;Exhibit;Hall;&;Events
•;Hail;&;Farewell;Luncheon
•;Gala;Reception;&;Dinner
•;Tuesday;Brunch
Day Rates
o Sunday, April 22 $350
•;Convention;Registration
•;Access;to;Exhibit;Hall;&;Events
•;Hail;&;Farewell;Luncheon
o Monday, April 23 $450
•;Convention;Registration
•;Access;to;Exhibit;Hall;&;Events
•;Gala;Reception;&;Dinner
Presidents Academy Hail & Farewell Luncheon;(Sun.)
Outstanding Alumni Gala Reception & Dinner;(Mon.)
Voluntourism (Community Service Project)
Brunch;( Tues.)
Preconvention Workshops (Space limited.)
#;tickets
_____________________________________
Card Number
_____________________________________
Expiration;Date
_____________________________________
Name as It Appears on Card
_____________________________________
Signature
Tax;ID;#;53-0196569
Virtual Annual Convention (Full description on AACC website.)
o Convention Registrant $99;(After;Mar.;23:;$129;;After;April;24:;$199)
o Non-registrant $249
TOTAL DUE
$;__________
Demographic Information
First;AACC;Convention?;o Yes o;No;First–time;CEO?;o Yes o No
Job Classification: (please;check;one)
o;President/CEO/Chancellor;o;Business;Officer;o;Vice;President;o Dean
o;Business/Industry;Liaison;o;Occupational;&;Technical;Programming;Officer
o;Government;o;Other;_____________________________________________
Cancellation and Privacy Policy
Cancellations,;substitutions,;and;refunds;requests;must;be;made;in;writing;to
2012;Annual;Convention,;One;Dupont;Circle;NW,;Suite;410,;Washington,;DC
20036.;All;refund;requests;must;be;received;by;March;23,;2012.;Refund;will;be;minus
the;following;cancellation;fees:;$250;;$100;spouse;and;day;rate;registration.;After
March;23,;2012,;no;refunds;will;be;given.;Approved;refunds;will;be;processed;after
May;31,;2012.;Participant;substitutions;can;be;made;at;any;time.;The;AACC;Privacy
Policy;is;available;on;the;AACC;website.
