Registration Form

September 19 – 20, 2016 • Caesars Palace • Las Vegas, NV

CONTACT INFORMATION
First Name _________________________________________ Last Name ___________________________________________

Company ______________________________________________ Business Title _____________________________________

Address _______________________________________________________________________________________________

City ___________________________________________________________ State ____________ Zip ___________________

Phone ______________________________________________ Fax _______________________________________________

Email _________________________________________________________________________________________________

SELECT YOUR REGISTRATION CATEGORY: COMPLETE YOUR PROFILE:

Job Type
q Standard
q Consultant
Loyalty: $999 (ends 6/23) Early Bird: $1,199 (ends 7/21) q Executive (Owner, Partner, CEO, CFO, COO, Sr. VP, etc)
Advance: $1,399 (ends 9/1) Regular: $1,499 (begins 9/2) q Finance
q Government (Regulator, Policymaker, legislator, etc)
Registration Includes: q Legal
• All Conference and Keynote Session • Online proceedings q Management (Sr. Director, Managing Director,
• Networking Events • Lunch on Monday and Tuesday Director, Corporate Manager, etc)
q Principal
q Project Developer
q Senior Consultant
q Electricity Provider q Senior Strategist
q Other:______________________________
Loyalty: $899 (ends 6/23) Early Bird: $999 (ends 7/21)
Company Type (Select one):
Advance: $1,099 (ends 9/1) Regular: $1,199 (begins 9/2)
q Consulting Firm
Registration Includes: q Investor Owned Utility/Crown Corporation
q Federal Power Agency
• All Conference and Keynote Session • Online proceedings
q Government (Federal , State, Municipality, etc)
• Networking Events • Lunch on Monday and Tuesday q IPP
q Irrigation District
q Legal Firm
q Municipal Power Agency
q Government/Academia q Public Power
Loyalty: $899 (ends 6/23) Early Bird: $999 (ends 7/21) q PUD
q Tribal Entity
Advance: $1,099 (ends 9/1) Regular: $1,199 (begins 9/2) q Other:_____________________________
Registration Includes: Primary Company Focus (Select one):
• All Conference and Keynote Session • Online proceedings q Electricity Generation
• Networking Events • Lunch on Monday and Tuesday q Power Marketing
q Public Policy
q Regulation
q Renewable Energy
q Additional Sponsor Personnel q Storage (Non-hydro)
q Transmission
All time periods: $899
q Water Resources
q Other:_________________________________

Continue on back
 September 19 – 20, 2016 • Caesars Palace • Las Vegas, NV

What is your primary reason for attending Western Power Summit? Would you like to receive a free subscription to POWER?
q Education q Yes
q Future Planning q No
q Networking
q Policy Education PAYMENT INFORMATION
q Sales/Product Promotion
q All of the above q Check q Wire Transfer q Invoice/Purchase Order
q Other:___________________________________________
Signature____________________________________________
What is your role in the purchasing process of your company/
Billing Address________________________________________
organization?
q Final City________________________________________________
q Recommend
q Evaluate State, Zip____________________________________________

What is your estimated annual volume of purchases in which you are Please make check payable to Western Power Summit/Access Intelligence
and mail to the below:
directly involved?
c/o Western Power Summit/Access Intelligence, LLC
q Not applicable P.O. Box 8737
q $1 - $19,999 Gaithersburg, MD 20898-8737
q $20,000 - $99,999
q $100,000 - $499,999 Wire Transfer Instructions:
q $500,000 - $999,999 ACCESS INTELLIGENCE, LLC.
q $1,000,000 - $4,999,999
q $5,000,000 - $19,999,999 Bank Name: Webster Bank, N.A.
q $20,000,000 - $49,999,999 Bank Address: 436 Slater Road, New Britain, CT 06053 USA
q $50,000,000 - $100,000,000 Bank Account: 0010747825
Bank Swift Address: WENAUS31
q More than $100,000,000 Routing Number: 211170101
Beneficiary: Access Intelligence, LLC
How many years have you attended Western Power Summit? Reference: Western Power Summit, Attendee Name(s) or Confirmation number(s)
q This is my first year **Please add an additional $95 for all wire transfers to cover the wire transfer fee.
q 2 years
q All 3 years

HOTEL INFORMATION
Discounted Hotel Rate Deadline: Thursday, August 16, 2016
Caesars Palace
3570 S Las Vegas Blvd
Las Vegas, NV, 89109
USA
Discount Reservation Phone (866) 227-5944, reference group code SCORM6
Website https://www.caesars.com/caesars-palace
A discounted rate of $209 per night has been secured for Western Power Summit and OR Manager Conference participants at Caesars Pal-
ace. Reservations can be made online or by calling Caesars directly at +1-866-227-5944 and referencing the OR Manager Conference or by
using group code SCORM6.

We are partnering with the OR Manager Conference to bring you this discounted rate.
Cancellation policy:
Cancellations received in writing on or before June 24, 2016 are fully refundable. No refunds allowed after June 24, 2016. Substitutions allowed at
any time provided Event Management is notified. All cancellations and substitutions must be in writing. Requests for refunds will be subject to a $95
processing fee.

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