Translating for the Pharmaceutical Industry
An ATA Professional Development Seminar
Wyndham Condado Plaza Hotel and Casino San Juan, Puerto Rico January 24, 2004

Registration Form

First Name:___________________ Middle Initial:___ Last Name:___________________ ATA Member #:_________

Employer/School:________________________________________________________________________________
                                (Only list employer or school if you want it to appear on your badge)

Street Address:___________________________________________________ City:__________________________

State/Province:___________________________ Zip/Postal Code:______________ Country:___________________

Primary Telephone:____________________________ Secondary Telephone:_______________________________

Fax Number:_____________________________ Email Address:_________________________________________

Seminar Registration Fees: ATA Member Nonmember* Payment *JOIN ATA NOW!
Individuals who join ATA when registering for this seminar qualify for the ATA member registration fee.
Please contact ATA or visit www.atanet.org/membapp.htm for a membership application.
Early-Bird (before January 16) $145 $260 $________
Onsite (after January 16) $215 $330 $________
Pharmaceutical Plant Tour Fees: $70 $95 $________
NOTE: If tour does not meet required number of participants by January 16, tour may be canceled. Full refund of tour fee will be issued if cancellation occurs.
TOTAL:
$________

Cancellation Policy: Cancellations received in writing by January 16, 2004 are eligible for a refund. Refunds will not be honored after January 16. A $25 administrative fee will be applied to all refunds.

[  ] Check/Money Order: Please make payable, through a US bank in US funds, to American Translators Association.
[  ] Credit Card: Charge my     [  ] American Express     [  ] VISA     [  ] MasterCard     [  ] Discover

Card No. ___/___/___/___/___/___/___/___/___/___/___/___/___/___/___/___ Expiration Date:___________

Name on Card:__________________________________ Signature:__________________________________

Please send payment and completed form to: ATA, 225 Reinekers Lane, Suite 590, Alexandria, VA 22314.
OR, if paying by credit card, please fax completed form to: (703) 683-6122.

__Please check here if you require special accessibility or assistance. (Attach a sheet with your requirements.)


An ATA certification exam sitting will be held on Sunday, January 25. This will be a standard exam, not specialty-specific. Please visit http://www.atanet.org/accred.htm to obtain the Registration Form.

For more information about ATA Membership, please visit the ATA website
at http://www.atanet.org or contact ATA at (703) 683-6100 or ata@atanet.org.