CLEAR Conference 
Registration Form
�September 15-17, 2005�
�Phoenix, AZ�


Click here for a copy of the conference flyer

Please note: After 4:00 p.m. Eastern on Friday, September 9, we will be
unable to accept further online registrations.  After this time, please
register in person at the conference.  Thank you.

If you are registering for the NCIT program only, please use the NCIT registration form (click here)

Name:

Title:

Organization/Agency:

Address (include city, state/province and zip/postal code):

Phone:

Fax:

E-mail:
(You will receive a registration confirmation at the e-mail or fax number you entered above.)

Please check this box if this is your first CLEAR conference:

Please check here if you have a disability and may require special accommodations to participate fully in this program. CLEAR staff will contact you.

Please keep me informed via fax or e-mail of future CLEAR programs and events.


Conference Registration (includes pre-conference workshops)
IMPORTANT: If only attending a training program, select "I am attending a training program only" 
from the drop-down box. 
(Otherwise, you will be registered for the conference by default.)

A $20.00 US/ $32 CAD fee will apply to ALL conference registrations received after 8/19/05.

* If you are not a member, you can join CLEAR now and qualify for the member registration fee. Click here for further details.

Check here if you plan to attend the CLEAR luncheon on Saturday, September 17 ($10 US/ $15 CAD will be added to the registration fee):

Check here if you have any dietary restrictions for conference food functions (a CLEAR staff member will contact you):

Please select here if you plan to attend (included in conference fee)
From Silver to Gold: Ethics Workshop (Wednesday, 5:00-6:30p.m.)
-- (Please select only one Thursday morning option) --
Board Member Training (Thursday, 8:00-11:00a.m.)
Pre-conference workshop: 25 Years of Experience in Developing Tests (Thursday, 8:00-11:00a.m.)
Pre-conference workshop: Sterling Test Security Practices (Thursday, 8:00-11:00a.m.)


Training Programs
IMPORTANT: If only attending a training program, select "I am attending a training program only" 
from the drop-down box for Conference Registration above. 

NCIT Program (September 13-15)
Basic: Please note - the Basic Program is now full and no further registrations will be accepted.
Specialized: Please note - the Specialized Program is now full and no further registrations will be accepted.
How did you hear about the NCIT Program?
(NCIT attendees are also invited to attend the annual conference Investigator Roundtable and Professional Discipline track sessions on Friday and Saturday at no extra charge.)

Regulatory Leadership Development Training (September 12-14)
Member @ $400 US/ $640 CAD
Other @ $600 US/ $960 CAD*
(does not include Conference registration)

*If you are not a member, you can join CLEAR now and qualify for the member registration fee. Click here for further details.


Additional Comments:

Payment: I have paid online       I am sending a check

Payment can be made in US or Canadian funds. Payment does not have to accompany registration; however, a registration form must be submitted to CLEAR for each attendee before that attendee can be considered officially registered. For those not paying with registration, invoices will be mailed shortly after the conference. Make check payable to: CLEAR, Federal Identification Number 61-1267676. Mail registrations to: 403 Marquis Avenue, Suite 200, Lexington, KY 40502. You may also register by fax at (859) 231-1943. Registrant substitutions are always welcome. Registrants may cancel up to August 19, 2005 and receive a full refund. After that date, a $50 service charge will be subtracted from refunds. Registration fees for the CLEAR conference include evening receptions, coffee breaks, and the conference registration packet. NO REFUNDS WILL BE MADE AFTER THE OPENING SESSION.
If you have questions about the general conference, call (859) 269-1802. For questions about NCIT or Board Member Training, call (859) 269-1601. 

CLEAR accepts payment online. After you have clicked "Submit Registration" above, just come back to this page and click the Buy Now logo: