Organization Design Forum

Please complete this on-line form to register for the ODF 2010 Annual Conference to be held in Denver, CO, May 4–6, 2010 (preconference workshops on Monday, May 3, 2010). Please note that this is not a secure site so please contact Brenda Price, ODF Office Administrator, at 919-662-8548, or email Brenda at b_r_price@bellsouth.net with any credit card information.

For more information you may also send an email to info@organizationdesignforum.org.

	Please register the following person for the conference
	Please register the following person for the conference and the Holacracy preconference workshop
	Please register the following person for the conference and the Strategic and Systems Thinking preconference workshop
	Please register the following person for the Holacracy preconference workshop (workshop only)
	Please register the following person for Strategic and Systems Thinking preconference workshop (workshop only)
	Please send me a complete brochure
	Please send me membership information

Name:
Title:
Organization:
Address:
Address (cont.):
City:
State:
Zip:
Country:
Phone:	(please include area/country code)
Fax:
Email Address:
Method of payment:	Check Visa/MasterCard: I will phone or fax in my card number Please bill against P.O. Number:

In order to better understand our participants and design the conference for them, please put a mark in all the boxes that pertain to you.

	I am an internal Organization Design consultant
	I am an external Organization Design consultant
	I am a management consultant
	I am a manager of a business unit function (please write in type of unit in line provided)

	I am in Human Resources

Number of years experience:

1–5 years

6–10 years

Over 10 years

Conference Fees:

Member Conference Fee $1600
Non-Member Conference Fee $1650
Conference Fee + Membership $1710

Early Bird Discount (registration received and paid by January 31, 2010) $200 discount

Student Conference Fee $700
Preconference Workshop $495
Large Group Discount (4 or more from the same Corporation) 10% discount on applicable conference registration fee.

You may now pay for conference registration fees via PayPal see above (After submitting this form you will be taken to a confirmation page with links to our Paypal cart page).
paypal logo

If paying by credit card, please provide the following information by phone or fax:

Specify Visa or Mastercard
Account number
Expiration date
Name on card
Signature

2010 ODF Conference & Pre-Conference Admission & Cancellation Policies:

The Organization Design Forum (ODF) seeks to register all interested registrants to its conference and pre-conference sessions. Nevertheless, ODF reserves the right to deny registration to any individual because of space/capacity considerations or for any other reason.
Cancellations of individual conference or pre-conference registrations made anytime up to April 7, 2008 will be refunded subject to a $250 cancellation fee.
Cancellations made after April 2, 2010, as well as no-shows are subject to the full registration fee.
Substitutions can be made at any time at no additional charge.
Cancellations and substitutions will be accepted by phone (919.662.8548), fax (919.662.9751) or e-mail (b_r_price@bellsouth.net).
The Organization Design Forum (ODF) reserves the right to cancel or reschedule this event, in whole or part. Please be advised that ODF is unable to assume responsibility for any airfare penalties, travel or hotel charges that may be incurred due to sold out, canceled or rescheduled events.
Payments must be received by April 2, 2010

Please make checks payable to Organization Design Forum and mail to:

Organization Design Forum 5713 Carriage House Court Apex, NC 27539