2015 REGISTRATION FORM AUGUST 18-20, 2015 power-gen

AUGUST 18-20, 2015
GREATER COLUMBUS CONVENTION CENTER
COLUMBUS, OHIO
power-gennaturalgas.com
2015 REGISTRATION FORM
Please Print
First Name Last Name
Title Organization Address 1 Address 2
City
State
Country
Postal Code
*Telephone
*Fax
Zip
Email
*Please include country and city code. Registration confirmation will be sent via e-mail, if an unique e-mail address is provided above.
You may receive reminders and information about POWER-GEN International via e-mail.
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I want to start/renew my free digital subscription to Power Engineering magazine.
Yes
No
Signature ______________________________________________________________ Date _________
TYPE OF COMPANY OR ORGANIZATION
Business functions, product or service the company performs, NOT the industry it targets.
10
89
Oil/Gas Company - Integrated, State-Owned,
Independent
02
Municipal Electric Utility
03
Rural Electric or Other Electric Cooperative
39
Other Public Electric Utility, including Federal, State or
District
Other industries (including Textile Mills, Coal &
Petroleum Products, Rubber & Leather, Stone, Clay,
Glass and Food & Kindred Products)
onsulting/Engineering/Construction Company
C
engaged in projects or providing services for an oil
and/or gas company
04
94
09
Independent Power Co., Unregulated Utility Subsidiary,
Cogenerator or Small Power Producer
Power Plants plus Service and Commercial
Establishments
30
Contractor
19
Original Equipment Manufacturer (OEM)
50
Financial
26
Pulp & Paper
25
IT & Software Solution
60
Service/Supply
28
Chemicals and Allied Products
98
Other (please specify) __________________________
65
Government/Library/Education
34
Fabricated Metal Products, Primary Metals & Mining
_________________________________________________
01
Investor-Owned Electric Utility
35
Machinery including Electrical & Electronic
JOB FUNCTION
Business functions, product or service the company performs, NOT the industry it targets.
02
General or Corporate Management (CEO,Pres, VP.
Partner, Director,Manager, etc.)
07
Other Engineering
98
08
Operations Management
_________________________________________________
Other (please specify) ___________________________
03
04
Superintendent/Field/Professional/Foreman
Engineering Management
10
Operations, including Maintenance
06
Engineering/Technical/Geoscience including Design,
Systems and Planning
12
Purchasing/Consulting
11
Other Operations
WHAT FORMS OF ENERGY ARE USED AT YOUR COMPANY OR WHAT FORM IS
YOUR COMPANY INTERESTED IN?
01
Nuclear
05
Coal
10
02
Oil
06
Waste
11
03
Natural Gas
07
Wind
08
04
Hydro
08
Solar
Bio Fuels
Marine Hydrokinetics (MHK)
Other (please specify) _____________
Choose one of four easy ways below to register for POWER-GEN Natural Gas:
Fax:
Direct: +1-918-831-9161
Toll-Free: 888-299-8057
Email:
[email protected]
Web:
www.power-gennaturalgas.com
Address:
Power-Gen Natural Gas
PennWell C&E Registration
P.O. Box 973059
Dallas, TX 75397-3059 USA
For questions, please call:
Direct: +1-918-831-9160
Toll-Free: 888-299-8016
1. CONFERENCE FEES
Conference fees include three day Conference, Keynote Session, Mega-sessions, Plenary Session, Exhibition, Exhibit Floor Receptions, Online
Conference Proceedings and Delegate Lunches.
Individual
❍ Paid by 7/18/15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $495
❍ Paid after 7/18/15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $595
Government Agency
❍ Paid by 7/18/15. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $350
❍ Paid after 7/18/15. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $375
International (Non-U.S. Residents)
❍ Paid by 7/18/15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $350
❍ Paid after 7/18/15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $375
Single Day (Does not include conference proceedings)
❍ Paid by 7/18/15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $300
❍ Paid after 7/18/15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $350
Exhibitor Delegate
(Must be exhibiting company of POWER-GEN Natural Gas 2015)
❍ Paid by 7/18/15. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $260
Student (ID is required)
❍ Student. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $250
Gas/Power Industry Partner (Send UNLIMITED employees for
one flat rate. Restrictions apply.)*
❍G
as
Producer___ / Pipeline___ / Processing___ (please make a selection) . . . . . $500
❍ Power Generator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $500
*R
egistration is checked to confirm applicant is from an approved company in
order to qualify for discount.
2. EXHIBITION ONLY
Includes Exhibit Hall access, Keynote Session and Exhibit Floor Reception only.
❍ Exhibition Only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $75
3. DELEGATE LUNCH TICKETS
Tuesday and Wednesday Lunch is included in Delegate Registrations.
❍ Delegate Lunch Ticket Tuesday, August 18, 2015. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40
❍ Delegate Lunch Ticket Wednesday, August 19, 2015. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40
4. ONLINE CONFERENCE PROCEEDINGS
Only for those that are NOT registered as a Conference Delegate. Full Conference Registration includes the Online Conference Proceedings.
❍ Online Conference Proceedings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $195
For additional information regarding the event, please visit www.power-gennaturalgas.com
TOTAL PAYMENT DUE - Please add all selections and total here:
$
METHOD OF PAYMENT: Payment must be received prior to conference.
❍ Check enclosed (in U.S. funds only) (Please make payable to Pennwell/PGNG 2015)
❍ Wire transfer (Wiring information will be provided with invoice.)
❍ Credit Card: ❍ Amex ❍ Visa ❍ MasterCard ❍ Discover
Payment must be received by published date to receive early registration discounts. Cancellations must be received in writing by July 18, 2015, for a refund,
minus a $100 administrative charge. After July 18, 2015, refunds are not available. Substitutions may be made at any time, by contacting the registration department
IN WRITING at [email protected]
Card Number:___________________________________________________
Expiration Date:_ ________________________________________________
Name on Card:_ _________________________________________________
Signature:______________________________________________________
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