SUBSCRIBE/DISCOUNTS     CONTINUING EDUCATION     CONFERENCE PRICES     

1. Contact Information

Please print.

First Name / Given Name	Last Name / Surname	Name to appear on badge (if different)

Street Address / P.O. Box	City

State / Province / Region	ZIP / Postal Code	Country

Telephone	Fax	E-mail Address

Certification number (if applying for CEUs)

How are you involved in birth?

How many births have you attended? _________

How did you first learn about this conference?

What excites you about this conference?

Do you give permission for Midwifery Today to release your contact information to fellow registrants?

Recordings of classes may be made available for purchase. Do you give permission to be taped?

2. Class Selection

I will attend classes on these days (select all that apply):

Wednesday, March 11, 2009: Pre-Conference

Thursday, March 12, 2009: Pre-Conference

Friday, March 13, 2009: Day One

Saturday, March 14, 2009: Day Two

Sunday, March 15, 2009: Day Three

3. Subscribe to Midwifery Today  [ Optional ]

Subscribe to Midwifery Today magazine and Save up to $75 on Conference Prices! Subscribers to Midwifery Today are eligible for reduced conference prices. If you are not currently a subscriber, you can obtain registration discounts by subscribing at this time. Midwifery Today magazine is published four times per year. Each issue contains 72 pages of articles, stories, and opinions, written by midwives and other birth practitioners from around the world.

Address	Price for a subscription to Midwifery Today
	1 Year	2 Years
United States	$55	$105
Canada / Mexico	$65	$125
International	$75	$145

If you would like to subscribe to Midwifery Today, please select the appropriate box below and enter your subscription price in the Payment section of this form.

4. How to Determine Conference Prices and CEU Fees

1. Prices do not include transportation, overnight accommodation or meals. Look up the price in the table in Section 5, Conference Prices and Payment.
    
   

   Discounts

2. Note that the table shows discounted prices for those who register early and for those who are subscribers to Midwifery Today.
    
   Full-time students who register for three or more days may deduct 30% when they submit, with their registration, proof of their full-time student status. [The student discount does not apply to CEUs or subscriptions.] Enter the prices that apply to you on the lines provided in the payment section of this form.
    
3. Please pay your CEU fees at this time: CEU fees are shown in the table below.
    
   

   Organization	CEU Fees
   ACNM	$10 per day
   MEAC	$10 per day
   Oregon Board of Naturopathic Examiners	$10 per day

    
   

   Please check the boxes below for the CEUs you are requesting, and enter your total CEU fees in the Payment section of this form. Each day of the conference, including pre-conference and post-conference, is charged as a separate day.

   ACNM

   MEAC

   Oregon Board of Naturopathic Examiners

4. You may mail this form with your payment in U.S. funds to Midwifery Today. If you pay by credit card, you may also fax this form to Midwifery Today. (Do not send credit card details by e-mail.) Use the address or fax number at the bottom of this page.

5. Conference Prices and Payment

Register Early and Save up to $90! By registering early you become eligible for reduced conference prices. The early registration deadlines are November 17, 2008, and January 20, 2009. Registrations must be received in office at Midwifery Today no later than March 6, 2009. If you cannot mail your registration early enough for it to be received prior to March 6, 2009, please register at the conference.

* No discounts apply to subscriptions or CEUs.	Conference prices when your registration is postmarked on or before…				Conference prices when your registration is received in office by March 6, 2009; please do not mail registrations to be received later than this deadline.
	November 17, 2008		January 20, 2009
	Subscriber	Non-Subscriber	Subscriber	Non-Subscriber	Subscriber	Non-Subscriber
1 day	$130	$145	$140	$155	$150	$165
2 days	$260	$290	$280	$310	$300	$330
3 days	$335	$380	$360	$405	$385	$430
4 days	$455	$515	$490	$550	$525	$585
5 days	$575	$650	$620	$695	$665	$740

Register by mail, phone, fax or e-mail: The prices you pay are determined by the postmark on the envelope in which you return your registration form. If you register by telephone, fax, or e-mail, the date Midwifery Today receives your communication will be deemed to be the postmark date.

After March 6, 2009, registrations are only accepted in person at the conference. If you cannot mail your registration early enough for it to be received prior to this deadline, please register at the conference. Simply pay the March 6, 2009, prices when you arrive at the conference. Class offerings may be limited, so please contact Midwifery Today before you arrive.

Please calculate the amount you need to pay by completing the items below.

Enter your conference price from the table above.
If you qualify for the student discount (see the Discounts section above), enter the amount of your discount (multiply the amount on the previous line by 30%). Enter 0 if you do not qualify for the discount.
Subtract your student discount from your conference price.
If you are subscribing to Midwifery Today (see the Subscription section above), enter your subscription price. Enter 0 if you are not subscribing at this time.
If you are paying CEU fees (see the CEU section above), enter the total amount of your fees now. Enter 0 if you are not paying CEU fees at this time.
TOTAL PAYMENT - Add the 3 items above to calculate your total payment.

How will you make your payment? NOTE: All prices shown in U.S. dollars.

Payment by Check

If you pay by check or money order, make the draft payable to Midwifery Today. Payment must be made in U.S. funds. If a draft is returned for any reason, including non-sufficient funds, you will be charged a processing fee equal to 10% of the draft amount.

Payment by Credit Card

All credit cards will be charged in U.S dollars at the listed U.S. prices. We cannot make any guarantee of exchange rate. All fees for fund conversion are the responsibility of the customer.

Refunds

If you cannot attend the conference after you have registered and sent in your payment, you must call the office and let us know on or before the cancellation date. You will be refunded the amount you paid minus 30% for processing. The cancellation date for the conference is January 28, 2009. No refunds after this date.

Please complete the following items if you are paying by Visa or MasterCard.

Amount to be charged to your credit card
Account number (Visa/Mastercard)
Expiration date  [ month / year ]
Name as it appears on credit card bill  [ please print ]
Billing address if different from above  [ please print ]
Billing phone and/or email address  [ please print ]
Signature

6. Information

Conference Prices

Conference prices do not include meals, transportation or overnight accommodations.

Conference prices are determined by the postmark date on your registration. If you submit your registration by telephone, fax or e-mail, the postmark date will be deemed to be the date that Midwifery Today receives your communication.

Walk-in registrants pay the price listed in the table for March 6, 2009, when they arrive at the conference.

How to Submit Registration and Payment

Please read and complete all of this form. Then make a photocopy for your records.

You may mail this form with your payment in U.S. funds to Midwifery Today. If you pay by credit card, you may fax this form to Midwifery Today. You may also register by phone or e-mail. (Do not send credit card details by e-mail.) Use the Contact Addresses and Telephone Numbers at the bottom of this form.

Registrations must be received in office at Midwifery Today no later than March 6, 2009. If you cannot mail your registration early enough for it to be received prior to March 6, 2009, please register at the conference.

Location of Conference/Hotel

Hilton Eugene and Conference Center
66 E. 6th Avenue
Eugene, OR 97401
Phone: (541) 342-2000 or (800) 937-6660
Fax: (541) 342-6661
www.hiltoneugene.com

Please see additional information on the venue on our Eugene 2009 gateway page.

Contact Addresses and Telephone Numbers

Midwifery Today
P.O. Box 2672
Eugene, OR 97402-0223
USA

conference@midwiferytoday.com
1-800-743-0974  [ U.S. and Canada only ]
+1 541-344-7438
+1 541-344-1422  [ fax ]

Conference Updates

Up-to-date conference information can be found on the Midwifery Today Web site:

www.midwiferytoday.com/conferences/Eugene2009/

Disclaimer

Midwifery Today, Inc., cannot be held responsible for natural disasters, labor strikes, acts of war or other events that may cause the conference to be rescheduled. Midwifery Today, Inc., reserves the right to postpone the conference to another time, date and, if necessary, location. In the event of a conference postponement no refunds will be issued. Registrants can transfer their fees toward any other Midwifery Today conference.

Midwifery Today, Inc., reserves the right to substitute teachers and/or classes. The views and opinions expressed by teachers are their own and may not represent the views and opinions held by Midwifery Today, Inc., and its staff members.