On-Line Congress Registration

This is the early registration form for ANAEROBE 2006, to be held July 25-28, 2006 in Boise, ID USA.
Early registration is strongly advised as attendance will be limited. Confirmations will be sent to you via e-mail and in your delegate packet preceding the Congress.

REGISTRANT
Name: Degrees:

MAILING ADDRESS







CONTACT INFORMATION
Tel: Fax:
Email:


REGISTRATION FEES


On-line registration is available with credit card payment. Payment with checks and for students must be done by mail. No advance registrations will be accepted after July 14, 2004

Congress Registration includes Delegate packet, Abstract Book, admission to Congress sessions and poster areas, Continental breakfast, coffee breaks, Wednesday evening reception. Full registration also includes the Congress Banquet. Additional dinner tickets may be purchased separately.

Thru
June 2, 2006
After
June 2, 2006
ASA Members
Full Package (including Banquet)
Meeting Attendance Only

Non-Members
Full Package (including Banquet)
Meeting Attendance Only

Single Day
Days: Wednesday Thusday Friday

Student (send a copy of current ID)
Meeting Attendance Only

Number of Extra Banquet Tickets
$230
$170


$300
$240


$80 per day



$80


$60 each
$270
$210


$340
$280


$100 per day



$90


$70 each

Continuing Education Units:
Category I CME - 15 hours -- $15 (Pending Approval)
Laboratory Technicians - 15 hours -- No Charge
None

Pre- & Post-Congress Activities:
Anaerobic Identification & Susceptibility Workshop -- $65 ($85 after June 2)
Tour of World Center of Birds of Prey -- $20 per person (July 25)
River Raft Trip & Dinner -- $85 per person (July 28)


Hotel Reservations

The Grove Hotel - 245 South Capitol Blvd., Boise, ID USA www.grovehotelboise.com
Room Rates: $109 + tax per night (7/23/06 - 7/30/06)

Arrival Date: Departure Date:

Number of Beds

For guaranteed hotel rates, registration deadline: June 2, 2006.
Hotel Reservations will be guaranteed to the credit card number below.
A credit card imprint will be required upon check-in for payment.
For special arrangements, contact the hotel directly.
Hotel reservations can be cancelled by contacting the hotel directly, at least 24 hours prior to check-in.
No smoking is allowed in hotel rooms - Internet access provided.


CREDIT CARD PAYMENT

VISA - MASTERCARD - AMERICAN EXPRESS

Number:   Expiration MM/YY: