Registration Form 29th Intermodal Expo & Annual Membership Meeting


November 13-15, 2011 • Georgia World Congress Center • Atlanta, Georgia REGISTRANT


Please place a mark in any applicable box ( ) to indicate a permanent change to IANA’s database. Mr. Mrs.


Ms. I am a first-time attendee. First Name ________________________________________ MI ________ First Name/Nickname for badge _________________________________________


Last Name _____________________________________________________ Title _____________________________________________________


Company __________________________________________________________________________________________________________________________ Address ____________________________________________________________________________________________________________________________ City/State/Zip _______________________________________________________________________________________________________________________ Phone __________________________________________________________


Fax ____________________________________________________________


E-mail__________________________________________________________ NOTE: UNIQUE E-MAIL ADDRESS REQUIRED FOR EACH REGISTRANT. CLICK HERE TO REGISTER ONLINE WITH CREDIT CARD AT www.intermodal.org.


Register by September 16th and save up to $250! Advance registration fee applies only to those registrations received and paid by September 16.


Full registration includes all educational/social functions and admittance to the Exhibition Hall. Badge required for admittance. IANA member company full registration


Additional full registrant from IANA member company EXHIBITORS ONLY — Exhibitor additional full registration.


Non-member full registration — $200 (per company) of this registration fee may be applied toward IANA membership when you join by 12/31/11.


TUESDAY INDUSTRY AWARDS LUNCHEON — is included in full registration. Please check if you plan to attend the industy awards luncheon on Nov. 15. Additional tickets may be purchased onsite at a cost of $50 per person.


Trade shows only — Includes admittance to Exhibit Hall only. This registration does


not include admittance to the industry awards luncheon on Nov. 15. Tickets will be available for purchase onsite at a cost of $50.


Spouse Program Includes spouse tour, admittance to exhibit hall and Intermodal Expo Wecome Reception


Spouse program does not include admittance to the industry awards luncheon on Tues., Nov. 15. Tickets will be available for purchase onsite at a cost of $50.


Total Amount Enclosed $__________


Spouse Full Name__________________________________________________ First/Nickname for Badge _________________________ Please check if you plan to attend the spouse tour, Atlanta’s Historical Treasures, Monday, November 14.


PAYMENT INFORMATION


Payment must be made in advance by check or credit card (no exceptions). Make checks payable, in U.S. funds and drawn on a U.S.-based bank, to Intermodal Association of North America. Mail or fax to: INTERMODAL ASSOCIATION OF NORTH AMERICA, 11785 Beltsville Drive, Suite 1100, Calverton, MD 20705-4048; Fax: 301-982-4815. Faxed forms must include credit card information below.


Questions? Call 301-982-3400, ext. 332.


PLEASE NOTE: IANA reserves the right to charge the correct amount to your credit card if you select a registration fee that you do not qualify for. Check


American Express MasterCard Visa Credit card #: __________________________________________ Exp. date: _____________ Name of card holder:________________________________________________ Signature _________________________________________


CANCELLATION POLICY: Advance commitments by the Association will preclude refunds for cancellations received after October 15, 2011. Refunds will be processed for cancellations received in writing prior to October 15, 2011, less a $150 administration fee.


$315 $400 $450 $__________ $295 $325 $345 $__________


$875 $725 $345


By 9/16/11 After 9/16/11 After 10/14/11 Amount $745 $600 $345 $945


$1075


$995 $__________ $850 $__________ $425 $__________ $1195 $__________


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