Registration Form

Association of Professional Engineers of Trinidad and Tobago The Professional Centre Building 1st Floor, Unit A203 11-13 Fitz Blackman Drive South P.O. Box 935, Port-of-Spain Trinidad – West Indies

APETT ANNUAL TECHNICAL CONFERENCE 2014 “Engineering for Disaster Preparedness and Management” January 23rd – January 24th 2014 REGISTRATION FORM ATTENDEE DETAILS NAME: ORGANISATION: ADDRESS: EMAIL: TELEPHONE:

MOBILE:

PAYMENT

APETT Member Non-member Student

STANDARD $2400 $2700 $1000

DAY ONE $1600 $1800 -

DAY TWO $1000 $1200 -

All prices are VAT inclusive. Please indicate your method of payment: Cash

Cheque

Direct Deposit

Please make cheques payable to: Association of Professional Engineers of Trinidad and Tobago (APETT) Direct bank deposits can be made at any RBC Royal Bank branch to account number: 00091110040744. Deposit slip or other proof of deposit must be submitted with this registration form. Students must submit a copy of a valid student ID from a tertiary-level institution with registration. TERMS AND CONDITIONS • • • • •

Full payment must be made 10 working days from the day of invoice or by January 16th, 2014, whichever comes first. Registrations are transferrable at any time up to the start of the conference at no cost. Substitutions and/or cancellations must be submitted to APETT via email to [email protected] Cancellations made on or before December 23rd, 2013 will be refunded 75% of registration fee. No refunds will be issued to no-shows

I hereby confirm having read and agreed to the above terms and conditions.

Name

Signature

Date

Tel/Fax: 868 627 6697 Email: [email protected] URL: www.apett.org President: Margarita Leonard; President-Elect: Haydn I. Furlonge; Secretary: Danielle Steele; Treasurer: Simon Westcott; Vice Presidents: Matthew Julien and Neil Dookie; Asst Treasurer: Roger Chan Soo; PRO: Kerrin Burgess; Asst. Secretaries: Fazir Khan and Frank Barnes; Immediate Past President: Narine Singh