Printable Registration form for the
WEDA 2004 Governor's Conference on Economic Development

(Please print and mail with check payable to WEDA.)

NAME___________________________________________________________

TITLE____________________________________________________________

ORGANIZATION___________________________________________________

ADDRESS________________________________________________________

CITY/STATE___________________________________ZIP________________

PHONE_____________________________

FAX_______________________________

E-mail____________________________

WEDA Member __ Yes __ No   __ Please send membership information.

Please complete the following information to help us accommodate all participants. Yes, I will attend the:

__ Sponsor appreciation reception on February 11
__ Luncheon on February 12
__ Reception on February 12
__ Breakfast on February 13

REGISTRATION FEES
Check payable to WEDA.
__ $225
__ $250 at the Door

To cancel your registration, send a written request by Feb. 5 to WEDA, P.O. Box 1230, Madison, WI 53701 or fax it to 608-283-2589.

Payment Info:
VISA __ M/C __ Check Enclosed __ Please make your check payable to the Wisconsin Economic Development Association (WEDA)

Card # ________________________________________ Expiration _________________

Cardholder _______________________________________________________________

Signature ________________________________________________________________

Mail To:

WEDA
P.O. Box 1230
Madison, WI 53701-1230
Fax: (608) 283-2589 (For Credit Card Registrants Only)


A block of rooms has been set aside at the Concourse Hotel, 1 W. Dayton St., Madison (this block of rooms will be held until Jan. 22). There is a special rate of $92 single / $102 double, plus tax, for the event. Governor's Club rooms are available for $125 / $135, plus tax. To make a reservation, call 608-257-6000 or 800-356-8293 and identify yourself as a conference participant.

For directions and maps, please visit the Concourse Hotels web site at www.concoursehotel.com or call the hotel at 800-356-8293.