AMERICAN PUBLIC TRANSIT ASSOCIATION



American Public Transportation Association

2019 Transit Board Members & Board Administrators Seminar

Hyatt Regency Jacksonville

Jacksonville, FL

July 20 – 23, 2019

Register online at:

|Registrant Information (One registrant per form) |

| |

|Name: (First) ______________________________________ (Middle Initial) _____ (Last) ____________________________________ |

| |

|Badge Name (if different from above): _______________________________________________________________________________ |

| |

|Title: _________________________________________________________________________________________________________ |

| |

|Organization: ___________________________________________________________________________________________________ |

| |

|Mailing Address: ________________________________________________________________________________________________ |

| |

|City: _________________________________________ State/Prov.: ____________ Zip_______________ Country: _________________ |

| |

|Telephone: _________________________________________ Email: ______________________________________________________ |

| |

|Spouse/Guest (if attending) ________________________________________________________________________________________ |

|(additional fee required: see below) |

| |

|? Please indicate below if you have special dietary needs or require accessibility accommodation. |

|_______________________________________________________________________________________________________________ |

|Registration Categories: No Fee Special Categories |

| |When registering please indicate the size of the system you represent |

|This seminar is open to APTA operating Transit System Members only. | |

| |? Small System: 100 or fewer buses/vehicles |

|? Board Member ___$745 (by 6/21/19) ___$795 (after 6/21/19) |? Medium System: 101 - 500 buses/vehicles |

| |? Large/Multimodal System: over 500 buses/vehicles |

|? Board Administrator ___$645 (by 6/21/19) ___$695 (after 6/21/19) | |

| |No fee Special Category – Selecting one of the categories listed below |

| |requires pre-approval from APTA or additional verification. Please note |

|Additional Ticketed Items (separate fees required) |that you will have limited access to the conference, including no meals. |

|? Spouse/Guest: ____$125 | |

| |Email completed form to: hrachels@ |

|Spouse/Guest Fee is not applicable to fellow employees or industry professionals. This fees | |

|includes access to all social events. |? Speaker (valid only for session in which you are |

| |speaking) |

| | |

|? Welcome Reception Ticket for guest (only) _____$50 | |

|Payment Summary: |Cancellation Policy: |

|Registrations paid by check will NOT be processed without full payment. To pay by credit card,|Registration fees will be refunded, minus a 20% cancellation fee if a |

|register online at |request is received in writing and post-marked no later than June 26, |

| |2019. There will be no refunds after the June 26th deadline. |

|?Check – Include this form with your payment | |

| |By completing and submitting this Registration form, I agree to the |

|? I would like to apply a credit from a previous meeting. (Attach credit letter with this |registration deadline and cancellation polices. |

|registration form) | |

| | |

|Registration Fee: $__________ | |

|Guest Registration $__________ | |

|Ticketed Events: $__________ Total Due: $__________ | |

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Mail to:

Meetings Department

APTA

1300 I Street, NW

Suite 1200 East

Washington, DC 20005

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