Registration Form

INDIANA ENERGY CONFERENCE REGISTRATION FORM
CLE CREDIT APPLIED FOR

The Future of Energy: Challenges and Alternatives
October 6, 2010
University Place Conference Center
Indiana University/Purdue University Indianapolis Campus

REGISTRATION DEADLINE: SEPTEMBER 30

Registration Information:

Cost	$225 per person $125 per person for government employees $20 Binder Fee (optional)
IMPORTANT Presentation Materials available online	In order to keep conference fees at the lowest cost to you, the conference materials will be available online. If you prefer to have a paper copy, there are two options: * Materials will be posted on the website at www.indiec.com . The link to this information will be emailed to you prior to the conference. You may download these materials and print a copy to take with you. * You may opt to pay an additional registration expense to receive a binder with the printed materials at the time of the seminar.
Accommodations	Call University Place Hotel (317) 269-9000
Cancellation/Refunds	Refund requests will be reduced to a fee of $50. Substitutions are welcomed and encouraged at no charge. Please contact Kay Squires to designate a substitute.

There are FOUR easy ways to register:

MAIL this registration (with check payable to "INDIANA ENERGY CONFERENCE" to Kay Squires, Lewis & Kappes, One American Square, Suite 2500, Indianapolis, IN 46282.

FAX this registration with credit card information to Kay Squires (317) 639-4882

WEB SITE Complete the Registration Form below and submit

CALL Kay Squires (317) 639-1210 (be prepared to give credit card information)

Method of Payment:

CHECK payable to "INDIANA ENERGY CONFERENCE will be mailed to Kay Squires c/o Lewis & Kappes, P.C., One American Square, Suite 2500, Indianapolis, IN 46282

CREDIT CARD PAYMENT (processed through law firm of Lewis & Kappes, P.C.)

Visa MC Discover AmEx

Name of Cardholder
Account Number AND 3-digit code on back of card
Expiration Date

Registration Form:

Name of attendee(s)

Company

Street Address

City State Zip

Telephone

Fax

E-Mail

Registration Cost/Binder Fee

Please print confirmation form for your records after you submit your registration.

	MAIL this registration (with check payable to "INDIANA ENERGY CONFERENCE" to Kay Squires, Lewis & Kappes, One American Square, Suite 2500, Indianapolis, IN 46282.
	FAX this registration with credit card information to Kay Squires (317) 639-4882
	WEB SITE Complete the Registration Form below and submit
	CALL Kay Squires (317) 639-1210 (be prepared to give credit card information)

	CHECK payable to "INDIANA ENERGY CONFERENCE will be mailed to Kay Squires c/o Lewis & Kappes, P.C., One American Square, Suite 2500, Indianapolis, IN 46282
	CREDIT CARD PAYMENT (processed through law firm of Lewis & Kappes, P.C.)

Name of attendee(s)
Company
Street Address
City State Zip
Telephone
Fax
E-Mail
Registration Cost/Binder Fee

Return to Home