Registration Form

Fort Collins, Colorado, USA: July 13 – 20, 2017

Method of Payment: (select one) check____, credit card with PayPal____, Cash____

Notice: You may make a credit card payment using PayPal even if you do not have a PayPal account.

1) Register by mail and send a check with your completed registration form.
Print this form, fill it out, and send it with payment to Dr. Robert P. Ellis, Course Director.
Make check payable to “Biosafety and Biosecurity Course”.

Or,

2) Register by credit card through PayPal. Also print this form, fill it out, and send it to Dr. Robert P. Ellis robert.ellis@colostate.edu, Course Director.
(To Paypal button at bottom of page)

For what sessions are you paying?
a) Animal + General Sessions ($1900) ________
b) Plant + General Sessions ($1900) ________
c) Animal + General + Plant Sessions ($2100) ________
d) General Only Session ($1000) ________

*Payment by check: Complete and send this form with payment. Checks should be made out to “Biosafety and Biosecurity Course”. Send payment to:

Dr. Robert P. Ellis
Infectious Disease Annex (IDA), Campus Mail Stop 1690
Colorado State University
Fort Collins, CO USA 80523-1690

*Payment by cash: Print this form, fill it out, indicate payment will be in cash, and send the form to Dr. Robert P. Ellis. Make arrangements with Dr. Ellis to pay cash on–site prior to course session attendance.

Please type or print the following information and send with payment to Dr. Ellis:

Name:_______________________________________________________________________________

Affiliation:____________________________________________________________________________

Department of Affiliation: ________________________________________________________________

City:_________________________________ State:________ Zip/Country:_________________________

Phone:_______________________________________

E–mail: (type or print)____________________________________________________________________


*Payment by credit card through PayPal:

Note: You must do both a and b
a) Email Dr. Ellis the completed registration form with the above information, AND
b) Make your payment through PayPal or by check.

Select your sessions from the drop down window, and pay with button in box number 1.
If you are paying for someone else please insert their name and email in the comment box.

If you are paying a varied amount, pay with the button in box number 2.
If you are paying for more than one person, pay with button in box number 2.


1. Select a Section to Attend
Comment





2. Sessions to be attended
Names of registrants



REFUND POLICY: Registration fee full refund less 5%, if requested within 45 days of annual meeting; 50% refund from 44–22 days before annual meeting; no refund if requested 21 days or less before annual meeting.