Medical
Translation and Interpreting Seminar Sponsored by the American
Translators Association
Crowne
Plaza Northstar •
Minneapolis, Minnesota • July 10,
2004
First Name
Middle Initial
Last Name
ATA Member #
Employer/School
(only list employer or school if you want it to appear on
your badge)
UMTIA Member #
Street
Address
City
State/Province
Zip/Postal Code
Country
Telephone Number
Fax Number
Email
Address
Registration
Fees :
ATA/UMTIA*
Member
Nonmember
Payment
Early-Bird
(July 2)
$145
$260
$
Onsite
(after July 2)
$215
$330
$
*UMTIA
members can register at the ATA member rate.
Total:
$
JOIN
ATA NOW! Individuals who join ATA when registering
for this seminar qualify for the ATA member rate. Contact ATA or
visit www.atanet.org/membapp.htm
for a membership application.
Cancellation
Policy: Cancellations received in writing by July 2, 2004
are eligible for a refund. Refunds will not be honored after July
2. A $25 administrative fee will be applied
to all refunds.
Check/Money Order: Make payable to American Translators
Association, through US bank in US funds
Credit Card: Charge my
American Express
VISA
MasterCard
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Card Number
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Signature
Send
payment and completed form to: ATA, 225 Reinekers Lane, Suite
590, Alexandria, VA 22314.
OR, if paying by credit card, please fax completed form to: (703)
683-6122.
Please check here if you require special
accessibility or assistance. (Attach a sheet with your requirements.)