IMIA - International Medical Interpreters Association

		Lifelong Learning Webinars

		IMIA Boot Camp Series

		Annual Trainers & Administrators Symposia Sept. 6-8, 2013

		2014 IMIA Conference - January 16-19, 2014

		Past Conferences & Events

		IMIA Speakers

		IMIA Presentations

		Events Coordinator

IMIA Celebrates Its 25th Year Anniversary

Event Registration - October 5th Kentucky Forum

If you are an IMIA member, please log in now at http://www.imiaweb.org/members/default.asp and then come back to this form to preload the form and get the member discount rate.

Not a member? Apply for membership at http://www.imiaweb.org/members/application.asp.

Note: Please do not use foreign accents in the name fields.

First name (as it appears on badge)

Last name (as it appears on badge)

Title

Employer

Address

City

State/province

Zip

Country

Phone

Re-enter email

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Do you have any special needs? (accessibility, etc.)

Do you have any special dietary requirements?

I would like to volunteer at the event as:
Usher
Timekeeper
Technology Support
Scribe
Registration Table

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Sponsor Fees

At the STAR Level, a contribution of $500 will provide an exhibit table and inclusion of your organization's one-page promotional material in the program, as well as cover the registration fees for three individuals.
At the ADVOCATE Level, a contribution of $250 provides for the inclusion of your organization's half-page promotional material in the program, and will provide registration for two individuals.
At the SUPPORTER Level, a contribution of $100 provides for the inclusion of a quarter-page ad in the program and registration for one individual.

Please enter your Sponsorship Level (see above) and the Names and Emails of Individuals to register under your level:

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Event fee: $75.00. If you are an IMIA member in good standing, please login at http://www.imiaweb.org/members/default.asp then return to this registration form to receive the member's fee of $50.00. Otherwise, you will need to select a membership option below to get the member rate.

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Special Promotion:
Discounted Membership/Renewal fee for those who opt to pay for an IMIA membership (new or renewing) while also registering (and paying, if a registration fee applies) for an IMIA event registration. Payment for membership and registration must be made concurrently, while registering for the event, or up to a week after the event. Discounted fess are as follows:

$45 for 1 year (regularly $60) - a $15 savings
$80 for 2 years (regularly $100) - a $20 savings
$115 for 3 years (regularly $140) - a $25 savings

Special Promotion for those Outside the US:
If you are an interpreter who does not live in the US, you are eligible for a 6 month trial membership (for new, first-time members only). The IMIA is committed to expanding internationally and encouraging members to join from all over the world. This will enable you to have all the benefits and website access of members and then at the end of the period you can decide if you want to join the IMIA interpreters worldwide.

All you have to do is fill out an application form at http://www.imiaweb.org/members/application.asp and under notes put 'International 6 Month Trial'. Your application will be approved.

Yes, I will pay an additional discounted fee of $45 for an IMIA individual 1-year membership (vs regular $60, a $15 savings)
Yes, I will pay an additional discounted fee of $80 for an IMIA individual 2-year membership for (vs regular $100, a $20 savings)
Yes, I will pay an additional discounted fee of $115 for an IMIA individual 3-year membership (vs regular $140, a $25 savings)

PLEASE NOTE: After completing this form please immediately submit a membership application at http://www.imiaweb.org/members/application.asp

No, thank you

Add to mailing list:
I am not a member, but I want to be added to the IMIA non-member mailing list so I receive important notices.
Yes No

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Verification Code

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You will be able to submit your payment on-line after you click "Submit" below.

All Event registration transactions are final - no refunds will be granted once the transaction has been processed.