Register for the Conference

Below is the registration form for the Annual leadership conference. Please fill out all fields, before submitting the form. Due to the high volume of registrations we receive, there may be up to a five day delay in receiving your confirmation. If you have not received confirmation, after one week, please email the Academy, and we will verify your registration form was received.

Please do not call for payment, until you receive the email confirmation.

All active conference sponsors are listed in the pull down menu. If your organization is not listed, then you should select the standard rate.

Thank you for your support of the Chair Academy Conference.

Pre-Conference Skill-Building Workshops (Select only ONE)			Pre-Conference Skill-Building Workshops March 25, 2014 Full Day - $125.00 9:00 am to 3:30 pm This fee includes: coffee and juice in the morning, am refreshment break, and materials
		None
		The Trick to Being a Chair or Organizational Leader
		A Leader's Guide to Balance and Wellbeing
		Fostering Well-Being Through Strengths-Based Leadership
		Working With Values to Create Culture Change
	To read the session summary, please hover over the session title

Conference Registration Costs (Select only ONE)				Full Conference Attendance Includes: Three - Breakfasts Three - AM breaks Two - PM Breaks One Plated Lunch (March 27) Welcome Reception (March 26) Access to All General Sessions Complimentary Copy of Tom Rath's Eat Move Sleep (first 400 registrants)
	Full Conference Rates - March 26-28, 2014
		$545.00	Standard Conference Rate
		$495.00	Conference Sponsor/Chair Academy Member Rate

		$445.00	Conference Host Rate (St. Louis Community College Only)
	Single Day Conference Rates - March 26, 27, or 28, 2014
		$250.00	Wednesday, March 26, 2014 only.
		$250.00	Thursday, March 27, 2014 only.
		$100.00	Friday, March 28, 2014 only.

Participant Information (All fields mandatory)

Full Name:

Title/Position:

College:

Address:

City:

State/Province:

Postal/Zip code:

Country:

Email:

Verify Email:

Phone:

Fax:

Dietary Restrictions:

Please check this box if you are a Vegetarian
Please check this box if you have a Gluten Allergy

Special, more restrictive diets, should be addressed
with the Conference Hotel, they will endeavor to work with you.

Additional personal charges may apply.

Executive Assistant Name:

Executive Assistant Email:

Executive Assistant Phone:

Emeregency Contact Information

Full Name:

Email Address:

Phone:

Cancellation Policy
Notification of cancellation before the conference	Substitutions Permitted	Cancellation Fee
After 02/28/14	Yes	$250
No Notification/No Show	No	Full Registration Fee Cost
An invoice and confirmation email will be sent to you within 5 business days. Do not contact the Chair Academy until you receive the confirmation email with your invoice. Payments must be received IN FULL, prior to the Conference. Any and all cancellations MUST be submitted to the Chair Academy, in writing, via email. Checks are the preferred method of payment, but credit cards are accepted. We currently DO NOT have online payment capabilities. Credit Card payments can be made/processed Tuesday-Thursday
Please read the following conditions and sign below.
If you need to completely cancel your registration, it is your responsibility to contact the Chair Academy in writing to do so. Contact the Chair Academy at conference@chairacademy.com The Chair Academy will contact you to confirm any cancellation we receive. If the Chair Academy is not notified in writing of your cancellation and you do not attend, you will be charged the full amount. Your photo may be taken during the events being held at conference. Your image may be used in future Chair Academy promotional materials. This includes website, flyers, social media, and any other media format. By signing/submitting this form you have read and agree to the photo and cancellation policy.
Please type your name in the field below to agree to the above conditions.
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