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Fargo Film Festival FFF 2005 Page 1

Fargo Film Festival - FFF 2005 		Click image to see full document

"...I I I U.S. Premiere I I I I Fargo Premiere OTHER PUBLIC SCREENINGS, FESTIVALS AND AWARDS: ________________________________________________________________________________________________________________________ PAYMENT METHOD: MAIL ENTRIES TO: F A R G O F I L M F E S T I V A L 314 Broadway · Fargo, ND 58102 I I I I Check or Money Order Payable to "Fargo Film Festival" For $25 (Please do not send cash.) I I I I Please send me information about I I I I charge my credit card $25 (Please Circle One.) attending the Fargo Film Festival. M A R C H 2 ­ 5 , 2 0 0 5 Account # I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Account Expiration Date: Mo. _______ Yr. ______ RELEASE STATEMENT: I have carefully read and understand the complete rules of the festival. I am..."
Fargo Film Festival Student FFF 2005 Page 1

Fargo Film Festival - Student FFF 2005 		Click image to see full document

"...your entry with submission as well as by e-mail to caity@fargotheatre.org OTHER PUBLIC SCREENINGS, FESTIVALS AND AWARDS: __________________________________________________________________________________________________________ PAYMENT METHOD: MAIL ENTRIES TO: F A R G O F I L M F E S T I V A L 314 Broadway · Fargo, ND 58102 I I I I Check or Money Order Payable to "Fargo Film Festival" For $15 (Please do not send cash.) I I I I Please send me information about I I I I charge my credit card $15 (Please Circle One.) attending the Fargo Film Festival. M A R C H 2 ­ 5 , 2 0 0 5 Account # I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Account Expiration Date: Mo. _______ Yr. ______ (Documentaries and Narratives) CATEGORY/GENRE: I I I I Narrative Feature I I I I Narrative Short..."
International Society for Mountain Medicine VIWCMM regform Page 1

International Society for Mountain Medicine - VIWCMM regform 		Click image to see full document

"...Name for Badge:_____________________ II. R EGISTRATION (in US dollars) Regular $400 ____ ISMM Member $350 ____ Student $250 ____ From Less developed Country (See list at www.ismmed.org/gdp.htm) $300 ____ Accompanying Person $200 ____ III. P AYMENT Registration Fee for Participant $______ Registration Fee for Accompanying Person $______ ISMM Membership (see www.ismmed.org/ismm_membership.htm) $______ Total $______ M ETHOD OF P AYMENT q Option 1: Credit Card:I hereby authorize ISMM to debit my credit card account for the total amount indicated above.This charge will appear on your credit card statement as "Wilderness Medical Society", which is processing these charges for the ISMM. You will receive a receipt from the ISMM at the conference, or by email if you wish. q Visa q MasterCard Card Number: _________________________________Expiration Date:_________Cardholder Name: ________________________ Signature of Cardholder: ___________________ q Option 2: International Money Order These must be in U.S. currency only, payable to ISMM. Your name and address must be clearly indicated. q Option 3: Check (for US delegates) These must be made..."
International Society for Mountain Medicine subs ismm Page 1

International Society for Mountain Medicine - subs ismm 		Click image to see full document

"...(apply to the President of ISMM in writing)** Payment by: Eurocheque [ ] Credit card [ ] Bank order [ ] Postal cheque (in CHF for Swiss members) [ ](tick appropriate) Signature: Place and date: _______________ * student member: anyone enrolled in an academic curriculum leading towards a degree.** complimentary membership is available for those who experience difficulty in paying their subscription Credit Card Form (to be completed by those who pay with a credit card):Name: Address City/Country_________________________________ Please charge my credit card for the amount of _________ Swiss Francs for the membership fees for the ISMM. AMEX:[ ]MASTERCARD/EUROCARD: [ ]VISA: [ ] No.: Exp. Date: __________ New membership:[ ] (y/n) Signature: ___________________________ Place and date:__________________ Send to: Dr.Bruno DURRER, Membership Secretary of the ISMM, Arztpraxis CH 3822 Lauterbrunnen,SWITZERLAND, Fax:++41 33 856 26 27, email: B.Durrer@popnet.ch..."
PrintAction epa call Page 6

PrintAction - epa call 		Click image to see full document

"...CONTACT INFORMATION _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ NAME _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ COMPANY _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ STREET ADDRESS _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ CITY/PROVINCE/POSTAL CODE _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ TELEPHONE/FAX _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ EMAIL _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ WEBSITE PAYMENT INFORMATION A cheque in the amount of $75 is enclosed, payable to Youngblood Publishing Ltd. or please charge credit card below: VISA American Express MasterCard _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ CREDIT CARD NUMBER / EXPIRY DATE _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ NAME AS IT APPEARS ON CARD _________________________________________________________________________________________________________________________________________________________________________________________________________________________________ SIGNATURE EPA.07 Most Environmentally Progressive Vendor in Canada EPA.08 Most Environmentally Progressive Printer in Canada (1 to 49 employees) EPA.09 Most Environmentally Progressive Printer in Canada (50 to 100 employees) EPA.10 Most Environmentally Progressive Printer in Canada (100+ employees) EPA.11 Most Progressive Print Consumer in Canada Please select EPA Category: EPA.01 Environmental Innovator EPA.02 Environmental Community Involvement EPA.03 Most..."
Wilderness Medical Society snowmass 2005 Page 166

Wilderness Medical Society - snowmass 2005 		Click image to see full document

"...· Don't leave anything of value in your car or your hotel room. · Be aware that when using hotel reservation services that there may be no connection with the hotel they book you into but they will be the ones that charge your credit card . · Check your hotel bill and make sure nothing has been added that you weren't aware of. · Check your hotel bill for telephone charges that you didn't make. · Be concerned if you see the switch board giving out rooms numbers or if you see a pile of room keys on a desk · Be sure there is a safe for your valuables · When not in your room, hang a DO NOT DISTURB sign on the door..."



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