If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Banff, Alberta, Canada 2017 IRMA Conference Evening Welcome Reception: Friday, October 13th Departure day: Tuesday, October 17th REGISTRATION FORM (Paying with Check) — Register each attendee separately — NOTE: You must be a member, sponsor, or authorized guest of IRMA to attend the conference. If you have any challenges while completing the registration, please contact Tiffany Davis at TulNet: 918.720.2704. firstname.lastname@example.org. Any other questions can be directed to Tara Flint, Executive Director, IRMA. Register each person separately. YOUR RELATIONSHIP WITH IRMA: Gold Sponsor Silver Sponsor Magazine Member Guest of IRMA / Honorary Member Company Inovva Solisco Choose your company Company Chilcutt Direct Marketing Cummings Printing MagNet Palm Coast Data Publication Printers Strategic Fulfillment Group The Magazine Manager UPM Wiland Select your company Magazine Title: Acadiana Profile Adirondack Life Alabama Magazine albemarle: Living in Jefferson's Virginia Arizona Highways Arizona Wildlife Views Arkansas Life Avenue Magazine BC Magazine Capital Region Living Colorado Life Cottage Life Delaware Beach Life Down East Downhome IRMA KANSAS! Louisiana Life Maine Boats Mississippi Magazine Missouri Life Mountain Home Nebraska Life Magazine New Mexico Magazine North Dakota Horizons Oklahoma Today Pennsylvania Magazine Saltscapes Texas Highways Traverse Vermont Magazine Wyoming Wildlife Minnesota Monthly Title (editor, publisher, VP, etc.) PERSONAL INFORMATION: First Name * Last Name * Email * Cell phone * Office phone * Office phone extension Address 1 * Address 2 City * State / Province * Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Pennsylvania Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'Ivoire Croatia (Local Name: Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Timor-Leste (East Timor) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And Mc Donald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic Of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic Of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia, South Sandwich Islands South Sudan Spain Sri Lanka St. Helena St. Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe Zip / Post Code Dietary requirements or Allergies (leave blank if none) Other Special Needs (leave blank if none) Arrival Date (estimate, displayed as DD/MM/YYYY) * Departure Date (estimate, displayed as DD/MM/YYYY) * IF YOU ARE COMPLETING THIS ON BEHALF OF SOMEONE ELSE: Please supply the following in case we need to contact you regarding this registration: Name Phone Email Parks Canada is sponsoring our Saturday evening Cocktail Party at the Cave & Basin hosted by John L. Thomson, Director, National Celebrations, Parks Canada and IRMA Honorary Member. Would you like to join your fellow IRMA members for an evening of learning about this National Historic site? Parks Canada is providing the shuttle to and from this pre-dinner event (cash bar). Afterwards, feel free to stay in downtown Banff for a night of IRMA Unplugged dinners, or ride the shuttle back to the hotel. Will you be joining us at the Cave & Basin? Please select. Please book your complimentary ticket here: Cave and Basin Cocktail Party hosted by Parks Canada – https://irmacon-2017-caveandbasin.eventbrite.com Attending Cave & Basin Yes, I would like to attend the C&B No, I would not like to attend the C&B On Sunday October 15th at noon, we are offering an excursion to Lake Louise. There are many activities to participate in including horse back riding, hiking and/or high tea at the Fairmont Hotel (more details and price list to follow). Would you like to book a space on the shuttle to and from Lake Louise for $45. Please book your shuttle ticket here: Lake Louise Roundtrip Shuttle Transportation - https://irmacon-2017-lakelouise.eventbrite.com (Please note that the shuttle trip includes lunch for registered members of the conference. There is an additional charge for unregistered for Guests.) Lake Louise Shuttle Booking Option 1 Option 2 SELECT THE REGISTRATION TYPE AND PAYMENT DETAILS Registration Selection * Select registration type Gold Sponsor, additional attendee, $575 Silver Sponsor, additional attendee, $575 Magazine member, additional attendee, $575 Family member, guest, no lunch / breaks, $350 Honorary member, full registration, $575 Guest publication, full registration, $775 Student, guest of IRMA, daily rate: $275 Opening Reception $95 Awards Reception and Dinner $145 Total Review the information above, then. . . Click SUBMIT below. You'll receive an email confirming this registration and notifying you of the amount due on this registration. You'll also receive a separate email from Executive Director Tara Flint with your invoice for this registration.