CEO Registration 2020

Reg ID

CEO Leadership Registration*

How Many Participants?*

Participant 1

Title

Name*

First Last

JOB TITLE*

ORGANISATION*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

SPECIAL DIETARY NEEDS*

TELEPHONE*

FAX*

Email

Do You Need Translation Services*

Yes
No

If so what language?*

Dutch
Spanish
French

Participant 2

Title

Name*

First Last

JOB TITLE*

ORGANISATION*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

SPECIAL DIETARY NEEDS*

TELEPHONE*

FAX*

Email

Do You Need Translation Services*

Yes
No

If so what language?*

Dutch
Spanish
French

Participant 3

Title

Name*

First Last

JOB TITLE*

ORGANISATION*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

SPECIAL DIETARY NEEDS*

TELEPHONE*

FAX*

Email

Do You Need Translation Services*

Yes
No

If so what language?*

Dutch
Spanish
French

Participant 4

Title

Name*

First Last

JOB TITLE*

ORGANISATION*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

SPECIAL DIETARY NEEDS*

TELEPHONE*

FAX*

Email

Do You Need Translation Services*

Yes
No

If so what language?*

Dutch
Spanish
French

Participant 5

Title

Name*

First Last

JOB TITLE*

ORGANISATION*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

SPECIAL DIETARY NEEDS*

TELEPHONE*

Email

FAX*

Do You Need Translation Services*

Yes
No

If so what language?*

Dutch
Spanish
French

Where/how did you find out about the CEO Leadership Conference?

Please Specify

Level of Participation

REGISTRATION FEES - DEADLINE DATE FOR REGISTRATION IS MAY 11TH, 2020

Category	Utility Members*	Associate/ Affiliate/IPP Members	Non-Members	Gov’t/ Regulator	Local Company
Early Bird Fee (Until April 17th)	$1225.00	$1350.00	$1800.00	$600.00
Conference Fee – (from 17th April until 15th May)	$1325.00	$1350.00	$1900.00		$900.00
Onsite Fee (from 15th May until 18th May)	$1375.00	$1500.00	$1950.00
Presenters	$750.00	$900.00	$1350.00

*CARILEC Utility Members from the Caribbean Region.

**Special rates apply for Board Members, Host Utility and HR Committee Members, contact conference@carilec.org for details.

PLEASE NOTE THAT REGISTRATION IS COMPLETED ONLY AFTER PAYMENT IS RECEIVED OR WITH PROOF OF PAYMENT.

ON-SITE REGISTRATION CAN ONLY COMPLETED WITH FULL AND IMMEDICATE PAYMENT.

WE ARE REGISTERING AS A:*

Early Bird Fee*

Early Bird Fee (Until April 17th)

Presenters

Utility Members
Associate/ Affiliate/IPP Members
Non-Members

ALL PAYMENTS MUST BE RECEIVED TWO (2) WEEKS PRIOR TO CONFERENCE DATE TO ENSURE REGISTRATION.

METHOD OF PAYMENT*

Please Enter Invoice # Below After Payment Is Made.*

Click Button below to make payment.

Checkout

An invoice /receipt of payments is sent via Email.

CHEQUES MUST BE MADE PAYABLE TO CARILEC

Banking Details:	corresponding bank details:
CARILEC,	WELLS FARGO
A/C No. 1129402	375 PARK AVENUE, NY 4080
swift: pnbpus3nnyc	NEW YORK 10152
cibc First Caribbean International Bank Ltd	SWIFT CODE: PNBPUS3NNYC
Bridge street	ABA NO. : 026005092
castries
saint lucia
Swift code: fciblclc

FORM COMPLETED BY*

Tel*

Email*

Please note the following:-

Registration is not complete without payment, and thus payment is due in advance
Copies of bank notices for telegraphic transfers must be faxed to CARILEC upon completion of transaction with bank
A 10% discount will be given to companies registering four (4) or more persons. Utility members registering two (2) or more persons receive a 10% discount. However, all registrations must be received together for discount to be applied.
Only one discount will be applied per registration
Registrations cancelled less than two weeks before the start of the conference will carry a 25% penalty

Offical use Only

Total before discount

Amount of Discount:

Total amount due:

Reason for Discount:

COMMENTS:

Signature