Registration
Form

Make a copy of this form.  Fill out the form, and send form and payment to:

Pat Harrington, Business Secretary-Treasurer
14840 Crystal Cove Court #503
Fort Myers, Florida 33919-7417

Phone:  (239) 437-4106 e-mail:  abta@earthlink.net

For Convention Details
Click Here

USE THIS FORM TO REGISTER


Send a check made out to ABTA for the Convention and/or Seminar registration fees.
Pat Harrington, Business Secretary-Treasurer
14840 Crystal Cove Court #503
Fort Myers, Florida 33919-7417
Phone:  (239) 437-4106 e-mail:  abta@earthlink.net

Non-US residents must pay either in  (1) US funds drawn on a US bank 
      (2) Canadian check in Canadian funds.   

Name    _____________________________________________________________________________________
 
Address   ___________________________________________________________________________________
 
 

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___________________________________________________________________________________ 



Phone_____________________________________________________

 
E-mail_____________________________________________________

CHECK ALL THAT APPLY:

           
  Register me for the Convention (Wed-Thurs)
   US funds fee: $150 fee ($175 after 6/15/05)
  Canadian funds:  $198 ($231 after 6/1/05)
              Register me for the Seminar (Tue-Wed)
  US funds fee: $40 fee in US funds
  Canadian funds: $54 
             Please register my guest(s) for the banquet ($80 US or $107 Canadian)
             Yes! Register me/us for the Wednesday evening Botanical Garden tour and dinner.  I have enclosed a separate check made out to ABTA for $50 per person. ($67 Canadian)
             Yes.  Make a reservation for me (us) for Tuesday dinner at Pitty Pat's Porch (separate checks to be provided). I understand that this is a firm commitment since reservations must be made in advance and will notify ABTA in advance of any change in plans.
             Check here if this is your first Convention or Seminar
             Check here if you will be wearing your own ABTA name badge (see below for information on how to purchase and order an ABTA name badge).

ORDER YOUR ABTA NAME BADGE NOW!

 
Marsden's, who provide our ABTA name badges, is located in Canada and the price including shipping is slightly under $20 Canadian (about $16 US funds).  You can pay with your credit card to avoid problems with currency conversions. The best way to place your order is by FAX: 
  Marsden's  contact:  John McGillivary
  FAX:  705-726-1103    PHONE:  705-726-1101
  Address: 4 Alliance Blvd., Unit 6   
Barrie, Ontario L4M 5J1
Canada