15 Welcome Celebration Guest Pass $75 each x ____ = $_______ For any guest accompanying you to this event, you must purchase a Guest Pass for each. Only 3-Day registrants may purchase Guest Passes. This pass only allows access to the Welcome Celebration. For details, visit www.atanet.org/conf/2019/registration. Buddies Welcome Newbies: I want to be a Newbie Buddy (must have attended 2 or more ATA conferences) (Optional; See page 4) My primary language pair is:____________________________ CONFERENCE REGISTRATION FORM Last Name First Name Middle Name ATA Membership# Street Address ( Please indicate if this is a new address) Apt/Suite City State/Province Zip/Postal Code Country Telephone Email (Use email of individual, not general company email) Emergency Contact Name and Telephone (optional) Company/School (Only enter if you want it to appear on your badge) I am voluntarily providing my personal information to ATA and I consent This will be my first time attending to having such information transferred to, processed, and stored in the U.S. an ATA Annual Conference. REGISTRATION FEES ATA Member Nonmember ATA Student Early Registration (by September 13) 3-Day Registration Saturday Only* $540 $270 $715 $360 $265 $135 Standard Registration (after September 13) 3-Day Registration Saturday Only* $700 $350 $930 $465 $345 $170 Late Registration (after October 4) 3-Day Registration Saturday Only* $915 $455 $1,210 $605 $450 $225 *Saturday Only allows access to sessions/events on Saturday, October 26 only. It does not allow the option to attend AST Courses, to purchase a Welcome Celebration Guest Pass, or to receive free access to the Virtual Conference. Badges cannot be picked up until Saturday, October 26 at 7:30am. Credit Card: VISA MasterCard AMEX Discover Credit Card Number Verification Code Expiration Date Name on Card Signature PayPal: To use PayPal, please visit www.atanet.org/paypal.php for instructions. Check/Money Order: Make payable through a U.S. bank in U.S. funds to ATA. Check Number: __________ Check Amount: __________ GRAND TOTAL (Add total conference registration fees here) = $ AST COURSES: 8:30AM - 12:00PM (Select one only) AST-2 $150 AST-4 $200 AST-6 $200 AST-3 $150 AST-5 $200 AST-7 $150 AST COURSES: 1:00PM - 4:30PM (Select one only) AST-8 $150 AST-10 $150 AST-12 $150 AST-9 $150 AST-11 $150 AST-13 $150 American Translators Association 60TH ANNUAL CONFERENCE Palm Springs, California October 23-26, 2019 JOIN ATA & SAVE Save up to $295 and receive 3 months FREE membership when you register and join ATA at the same time! Learn more at www.atanet.org/conf/2019/join. 3 WAYS TO REGISTER Register online at www.atanet.org/conf/2019 Fax this form to +1-703-683-6122 Mail this form to ATA 225 Reinekers Lane, Suite 590 Alexandria, VA 22314 USA CANCELLATION POLICY Requests received in writing by October 4, 2019 are eligible for a refund, subject to a $25 fee. Refunds will not be honored after October 4, even in the case of program changes/cancellations. For AST Courses, refer to policies at bit.ly/ata60ast. ATTENDANCE POLICY Registering for this conference constitutes an acceptance of ATA’s attendance policy. Review the full policy at ww.atanet.org/conf/2019/ registration. Consent to Use of Photographic Images Registering for this conference constitutes an agreement to ATA's use and distribution of image or voice of attendee in photographs and video/audio recordings. Photography and Recording Policy Photography or video/audio recordings (without the express permission of speaker) are strictly prohibited during all sessions and will result in expulsion from the conference without refund. FIT Members Discount If you are not an ATA member and are a member of an International Federation of Translators member organization, you may register at a discounted rate. Register online at www.atanet.org/conf/2019 to receive this discount. Please indicate if you require special assistance or accessibility and attach a sheet with your requirements. Select one: I am an independent contractor wanting to meet agency reps. I am an agency rep wanting to recruit independent contractors. You are primarily a: Translator Interpreter Other: ________________ Who is paying for your attendance? I am paying myself My employer is paying Both myself and my employer are paying OPTIONAL INFORMATION AST COURSE: 8:30AM - 4:30PM AST-1 $300 (This is a full-day AST. If selected, do not select any other AST.)