11th International Conference of Fire Service Women
Registration Form
(Print, complete, and mail -- Please use one form for each attendee)
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Phone #: |
| Address: |
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| City/State/Zip: |
| E-mail address: |
Fax #: |
| Please send my registration confirmation via: ___ e-mail ___ regular mail |
| Name of fire department or agency, if any: |
| Attendee's rank, title, or position: |
| I will need: |
___ Child care |
___ Vegetarian meals |
| x x (Must register by March 18 for child care) |
___ Interpreter: ___________________ |
| I would like information about: |
___ Room-sharing assistance |
___ Work-study options |
| ___ Map/driving directions to hotel |
___ Scholarships |
| ___ Post-conference trip |
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Registration payment policy: To be eligible for the advance discount, registrations must be postmarked and paid in full (or agency purchase order received) by March 18. Registrations received after that date will be due at the on-site rate.
Fees include all conference materials, a welcome reception on Wednesday evening, dinner Friday evening, and continental breakfasts Wednesday through Sunday. Package B and C fees also include an early-bird reception on Tuesday evening.
Refund policy: Registrations cancelled before March 11 will be refunded in full, except for a $25 administrative fee. Registrations cancelled between March 11 - March 28 will receive a 50% refund. There will be no refund for no-shows or for cancellations after March 28. Another individual may attend in the place of a registered attendee if written permission from the person or agency paying the registration fee is provided.
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Advance discount
(by March 18) |
Regular/on-site rate
(after March 18) |
Total |
Package A:
Thursday, March 31 - Sunday, April 3 |
WFS members: $350
Non-members: $380 |
WFS members: $420
Non-members: $455 |
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Package B:
Wednesday, March 30 - Sunday, April 3 |
WFS members: $520
Non-members: $550 |
WFS members: $625
Non-members: $660 |
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Package C:
Tuesday, March 29 - Sunday, April 3 |
WFS members: $575
Non-members: $610 |
WFS members: $690
Non-members: $730 |
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| Capitol Hill reception Thurs. 3/31 |
$15 |
$15 (if space is available) |
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| Friday 4/1 luncheon: |
$30 |
$30 |
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| Saturday night 4/2 reception and dance: |
$35 |
$35 |
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Extra tickets for guests (please indicate tickets needed):
[Tuesday tour $60; Tuesday reception $20; Wednesday reception $25; Friday luncheon $30; Friday dinner/auction $35; Saturday reception/dance $35; "I Love a Fire Fighter" workshop Saturday $10] |
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| (Optional) Donation to conference scholarship fund:* |
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| Total enclosed: |
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We offer a group discount for six or more participants registering together. To qualify for this discount, attendees must register at the same time and fees must be paid by the same check, purchase order, or VISA/MasterCard. Call us at 608/233-4768 for details.
*The conference scholarship fund is used to provide financial assistance to those who would otherwise not be able to attend the conference. All donations are tax-deductible as provided by IRS regulations.
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If you have included payment for Package B or C, please fill out the section below. Each participant will be able to attend two half-day sessions or one all-day session. Please indicate the workshops you wish to attend.
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Wednesday, March 30, all-day sessions (Choose one OR a morning & afternoon session, below): |
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___ The ABC's of Assessment Centers
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___ Structural Firefighting Operations
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___ First-In Fire Officer
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___ Search Procedures for RIT Operations
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Wednesday, March 30, morning sessions: |
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___ Stop "Putting Out Fires: How to Analyze Problems and Resolve Conflict
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___ Confronting Racism: Working Toward Racial Justice
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___ Preparing for "Chiefhood"
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Wednesday, March 30, afternoon sessions: |
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___ Mediating Disputes
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___ Communication, Culture, and Conflict
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___ Domestic Violence, Suicide, and Substance Abuse in the Fire Service
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____ I will be participating in the Wildland Issues Opening Session on Wednesday afternoon, March 30.
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| (There is no charge for the wildland issues session on Wednesday if you are registered for Package A. To participate in this event and the Tuesday National Mall visit, purchase a separate ticket for Tuesday.) |
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Return this form with your check (in U.S. dollars),VISA/MasterCard information, or purchase order number, to Women in the Fire Service, P.O. Box 5446, Madison WI 53705. Registrations paid by purchase order or credit card may be faxed to 608/233-4879. WFS' Federal ID# is 31-1087823. You will receive a letter or e-mail confirming your registration. If you do not receive this notification, please contact us again to make sure we received your form.
VISA or Mastercard:
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Expiration date: |
| Authorized signature (for credit card only) |
| Agency purchase order #: |
P.O authorized by: |
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Feel free to call us at 608/233-4768, or e-mail , with any questions about the conference. You may expedite your registration by us with all of the above information and then calling your credit card information to us at 608/233-4768. We do not recommend transmitting credit card data via e-mail.
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