________________
Address: Street / apt #
Residence Phone
First
Registration Fees:
Primary and Immediate Family Members (Spouse, Sons, Daughters and Parents)
Name
1.
2.
3.
4.
Mi.
5.
6.
Business Phone:
7.
8.
9.
Couple
Each Additional Immediate
Family Members
Individual
Last
Early Bird Jan 15, 2001 US $175.00
US $60.00
US $95.00
C/O Hitesh C. Shah, 821 Seers Dr.
Schaumburg, Illinois 60173-6198
email: 7hitesh@home.com
Phone for Convention Head Quarters: (847) 397-8316
City
(Postmark of registration from will determined applicable registration fees)
Please mail registration form and Checks payable to: JAINA 2001 Convention,
Sex M/F
Fax
10 / JAIN DIGEST. FALL 2000
REGISTRATION FORM www.jaina2001.com
State/Province
Jain Education International 2010_02
Jan 16 to April 15 US $200.00
US $85.00
US $120.00
E-mail
Marriage Info. Service (MIS) MM/DD/YY Relationship (US $50/person)
DOB
PRIMARY
Yes/No
SPOUSE
Yes/No
Amount
April 16 to June 15
US $235.00
US $110.00
US $150.00
Yes/No
Yes/No
Yes/No
Yes No
Date:
Zip/Postal code
June 16 to July 07
US $275.00
Member No
US $140.00
US $185.00
10. Organizers are not responsible for loss, injury or damage of any kind to registrants or guests. 11.
Check if have registered rooms at
(Name of hotel)
Registration Rules/Information
Online registration through Web site www.jaina2001.com will be available by November 30, 2000.
The registration fee is based on individual, couple or each additional family member. (For example family of 4 register before Jan 15, 2001, it will be US $ 175 + 60*2=$ 295). Additional fees apply for Youth cruise/Dance/Concert/MIS. Registered family with children's up to age 5 are FREE June 15th 2001 is the LAST DATE of pre-registration for Youth Cruise and Youth Dance/Concert.
Cancellation charges will be US $50.00 for total registration fee up to May 31. Cancellation charges will be US $50.00 or 25% of total registration fee (whichever is higher) from May31 to July 2,2001. Marriage Information Services (MIS), Youth Cruise & Dance/Concert charges are nonrefundable.
Youth Cruise (age 18-35)
(US $60/person)
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Most programs are at convention hail, Hyatt and Rosemont Suites Hotels (See attached map)
Receipt of confirmed registration will be mailed to you. Registrant must bring registration letter and picture ID at registration desk to collect registration material. All convention participants require Picture ID.
Updated DB
Country/Region
On site registration begins 12:00 noon on Thursday July 5, 2001. Only Cash or Credit Cards will be accepted during on site registration. The programs start Thursday evening, conclude on Sunday afternoon.
For Private & Personal Use Only
Profession (Primary's)
Total Amount Enclosed
US $
Charge my Master card / Visa / Discover / American Exp
Card # | || |டட டடடட LLLE டடடட
Name on Card:
Exp. DT: Date:
Signature:
You need to be registered for the convention and fill out separate Candidate Information Form to participate in Marriage Information Service (MIS). The cruise is scheduled for the 18-35 age group on Saturday for 3 hours. Youth concert for ages 18 and above will have live bands. Youth cruise, concert and dance will be served on first come first serve basis.
Youth
Dance(DJ) (age 12-17) Concert (age 18 or above) (US $10/person) Dance/Concert/None
Dance/Concert/None
Dance/Concert/None
Dance/Concert/None
Dance/Concert/None
Dance/Concert/None
Signature:
If you need help filling out the form, e-mail questions at jainaconvention@aol.com or go to www.jaina2001.com web site to see a sample. Convention official Use Only:
Receipt No
Date
Registration Fees <See chart
Donation
Total Amount
Checked by
US $$$ Amount
www.jainelibrary.org
