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October 20 - 22, 2008
Seven Feathers Conference Center, Canyonville


First Name Last Name
Organization



Address City State   Zip Code  
Telephone Fax Email
 

Lodging: $74.00 plus 8% tax for single and double until September 22, 2008 .  Contact the 1-800-548-8461 use Oregon Traffic room code.


Meals: Please plan for me to participate in the following meals:
10/20
 Opening Luncheon Dinner Reception
10/21
   Breakfast
 Awards Luncheon
 Dinner Reception
10/22
 Breakfast
 Closing Luncheon

Vegetarian Please Other Dietary Restrictions

Guest meal tickets (Breakfast - $12 Luncheon - $17 Reception - $24) 
I wish to purchase the following number of guest meal tickets.

10/20
  
 Opening Luncheon # Dinner Reception #
10/21
 Breakfast #  Awards Luncheon #
Dinner Reception #
10/22
 Breakfast #  Closing Luncheon #


Conference Fees: (please indicate participation in meals above)

Early Registration Discount by Sepember 22, 2008 $95.00
Checks or purchase orders for Early Registration Discount must be received by September 22, 2008
Full Conference $125.00
One Day Registration $60.00 each day (please indicate day(s): Monday Tuesday Wednesday
Amount Enclosed: $(Conference fee) + $ (Guest Meals) = TOTAL $


Traffic Safety Tours - To help with planning, please indicate your tour preferences:
Please indicate if you need accessible transportation for tours

10/21  Glendale Ambulance, Glendale Rural Fire Dept. and A and M Trucking - dispatch, shop and maintenance (2 to 5 pm)

Accessiblity: Location is ADA accessible. To request assistance for hearing impairment or specific accommodations, contact ACTS Oregon at safety@actsoregon.org or 503-643-5620.

(You may want to print a copy of this page for your records before submitting the form)

Oregon Transportation Safety Conference is sponsored by the ODOT Transportation Safety Division

 




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