2016 Pesticide Stewardship Conference

The Pesticide Stewardship Alliance
SPONSOR/INDIVIDUAL REGISTRATION FORM
DoubleTree by Hilton at the Albuquerque Convention Center
201 Marquette Avenue Northwest
Albuquerque, New Mexico USA 87102

(fields in red are required)
Contact Information
Name Additional Requests, Comments or Special Dietery Needs
Organization
Email
Phone
Address MEALS: Breakfast, lunch and the events listed below are included in the price of registration. Please mark which events you will be attending. For special dietary needs, please use the comment box above.
Grand  Reception, Tuesday, February 9
Breakfast, Wednesday, February 10
Annual Meeting Lunch, Wednesday, February 10
Breakfast, Thursday, February 11
Awards Luncheon, Thursday, February 11
Reception & Off Site Event, Thursday, February 11
First Time Attendee?
Click here for TPSA Conference Registration for Family Members or Guests
City
State/Prov
Postal Code
Country

 

*Family Members & Guests must register to attend the events and pay fee for each person to attend. Please register family members by clicking on this link.
 
STEP 1. Conference Registration
$450

Full conference registration(s) until 1/18/2016 (after: $450.00 for member)

($450)

Third attendee FREE for government and not-for-profits reduction
(select at least three attendees above)

$475

Full conference registration for non-members until 1/18/2016 (after $475 for non-members)

$325

One day registration - Wednesday, Feb.10


$325

One day registration - Thursday, Feb. 11

($100)

Registration fee reduction for session presenters

($50)

Registration fee reduction for poster presenters
(limit one deduction/poster)

   
 
STEP 2. Membership - The Pesticide Stewardship Alliance - 2016 Membership Form - September 1, 2015 -
August 31, 2016 (not a part of Conference Registration)
Membership Type - If appropriate, make a selection of membership type:
Individual – $75 (Membership is free to Sponsors contributing $500-$4,999.)
Provide full name, address, phone number and email below.

(Listed for TPSA Membership)
Organization – $200 (Membership is free to 3 members per organization in an organizational membership. Also, free to Gold Sponsors contributing $5,000 or more)
Provide full names, addresses, phone numbers and email below.

(Listed for TPSA Membership)
     

STEP 3. Affiliation of Membership: Each member please select one of the following areas of affiliation that represents your primary personal/professional area of focus within TPSA.


Choosing one affiliation per member does NOT prohibit any TPSA member from being actively involved in any TPSA committee, group, meeting, or voting. Affiliation records serve to assist with Conference planning, Membership assessment, BOD nominations, and overall Organization focus.

UNITED STATES ENVIRONMENTAL PROTECTION AGENCY (U.S. EPA)
Individuals employed by the U.S. EPA.
GOVERNMENT AGENCY

Individuals employed by a local, state or federal agency (except the U.S. EPA).

PESTICIDE INDUSTRY
Entities or organizations that manufacture, formulate or distribute pesticides;
manufacture or distribute pesticide containers; conduct pesticide research, education,
training or consultation; manufacture, sell or distribute equipment and/or other products
that are utilized in any aspect of pesticide manufacture, commerce, packaging,
transport, application, use, and storage; and pesticide industry
sponsored and funded organizations that undertake pesticide stewardship activities.
WASTE MANAGEMENT INDUSTRY
Entities or organizations that identify, package, or transport waste pesticides and residues,
recycle waste pesticides and residues and/or pesticide equipment or containers or manufacture
equipment to accomplish any of the above; and any waste-management industry sponsored
and funded organizations that undertake pesticide stewardship activities.
PESTICIDE CONTAINER MANAGEMENT INDUSTRY
Organizations that are involved in any aspect of pesticide container management and
any pesticide container management industry sponsored and funded organizations that are
involved with pesticide stewardship activities.
INSTITUTIONS

Entities that are involved with research, teaching or extension in an
area or areas of pesticide stewardship.

END USERS

Individuals or businesses that use or apply pesticides and organizations,
trade associations or commodity groups that represent end-users or applicators.

PUBLIC OR ENVIRONMENTAL HEALTH
Individuals and organizations that are involved with environmental and natural resource
protection, recycling, pollution prevention or other conservation or ecological issues and any
other corporations that do not fit into any other category.
NON-AFFILIATED
Individuals and organizations that do not wish to identify with or do not fit into an area of
affiliation listed above.
   
STEP 4. Sponsor Information - For those who wish to support TPSA
  Gold Sponsor
$5,000+

    Silver Sponsor
$1,000 - $4,999

    Bronze Sponsor
$500 - $999

 


  • Free annual membership, for one year, for three members of the sponsoring organization.
  • Free booth space at the Annual Stewardship Conference.
  • Recognized on the TPSA home page and all conference sponsor materials.
  • Special recognition at the Annual Stewardship Conference and annual members meeting.
 


  • Free annual membership, for one year, for one member of the sponsoring organization.
  • Free booth space at the Annual Stewardship Conference.
  • Recognized on the TPSA home page and all conference sponsor materials.
  • Special recognition at the Annual Stewardship Conference and annual members meeting.
 


  • Individual sponsors are recognized during the annual conference.
  • Free booth space, if requested and available, at the Annual Stewardship Conference
  • Specific Sponsor
    Call 314 849-9137 for details
    Provide financial sponsorship for specific conference events.
  FREE Table top display or
10' Display

STEP 5. Payment

Payment - pay with credit card or if paying by check, make payment to TPSA with a copy of the registration form and mail to TPSA, 11327 Gravois Road, Suite 201, St. Louis, MO 63126.

To pay with credit cards, click below. You do not need to have a PayPal account to use this function. If paying by PayPal and paying for someone besides yourself – please include their name(s) to ensure payment is applied to proper person.

Cancellations/refunds requested in writing, less $50 administration fee, will be made on/or before January 18th.
After January 18th only 50% of the registration fee will be refunded.

By paying for conference, attendee gives permission to be contacted by TPSA via email.

  Total


 
STEP 6. Hotel Reservations

DoubleTree by Hilton at the Albuquerque Convention Center
201 Marquette Avenue Northwest
Albuquerque, New Mexico USA 87102

Conference Registrations:
May be made by calling 1-877-280-0751 or booking online.  Be sure to say you are with The Pesticide Stewardship Alliance Annual Conference to get the special rate.


RATES:
     •  Corporate web-link:
http://doubletree.hilton.com/en/dt/groups/personalized/A/ALBSMDT-THE-20160208/index.jhtml

     •  Rate is $129.00 for single or $139.00 double plus applicable tax will apply to each room.

     •  Government web-link:
http://doubletree.hilton.com/en/dt/groups/personalized/A/ALBSMDT-PES-20160208/index.jhtml

Group Code: The Pesticide Stewardship Alliance Annual Conference.
Prevailing Government Per Diem (currently $89.00 for single or $109.00 for double) plus applicable tax will apply to each room.

     •  Rates are available for three days pre and post event dates, pending room availability.
     •  Check-in is after 3:00PM the date of arrival and checkout is before noon on the day of departure.
     •  Room block closes Monday, January 18, 2016.

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