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THIS PAGE (20D) OF THE REGISTRATION FORM WILL BE DESTROYED TO PROTECT YOUR CREDIT CARD INFORMATION.

REGISTRANT’S FULL NAME ______________________________________________________________________________________________________

FORM OF PAYMENT

REGISTRATION TOTAL

From page 20a

$

WIRE TRANSFERS

Wire transfers will be accepted only for registrants outside the United States. Register online and choose wire transfer as payment type. Wire instructions will be included in your confirmation.

CHECK

Checks must be payable in U.S. currency and drawn on a U.S. bank. Payment must accompany conference registration form.

  • Wire transfer
  • Enclosed is my check payable to NAFSA 2017

CREDIT CARD

  • American Express
  • MasterCard
  • VISA
  • Discover

__________________________________________ __________________________________________

Credit Card Number Expiration Date

____________________________________________________________________________________

Print name as it appears on card

____________________________________________________________________________________

Authorized Signature

PLEASE DO NOT INCLUDE CREDIT CARD NUMBERS IN E-MAILS TO EXPERIENT.

PAYMENT CARD INDUSTRY DATA SECURITY STANDARDS (PCI DSS) COMPLIANCE

NAFSA and its fulfillment vendor, Experient, comply with PCI DSS standards for organizations processing credit card transactions to increase controls around cardholder data to reduce credit card fraud. The methods approved by the credit card brands for sending credit card information to Experient are: faxing credit card information to +1.301.694.5124; providing credit card information to our Customer Service Department by calling +1.240.439.2960; or sending credit card information through a delivery method that can be tracked (like FedEx or registered USPS) to NAFSA, 2017 c/o Experient, 5202 Presidents Court, Suite G100, Frederick, MD 21703.

NAFSA WELCOMES YOU TO THE NAFSA 2017 ANNUAL CONFERENCE & EXPO

Please ensure that each page of your registration form is accurate and complete. Any incomplete registration form received will result in delayed processing. All dollar amounts are U.S. dollars.

All conference registration fees are quoted in U.S. dollars. Full payment in U.S. currency must accompany this registration form. Do not send cash or traveler’s checks. Make all checks payable to NAFSA 2017 and send along with completed registration form(s) to: NAFSA 2017, c/o Experient • 5202 Presidents Court, Suite G100 • Frederick, MD 21703 USA; fax with credit card payment only to +1.888.772.1888.

CANCELLATIONS, REFUNDS, AND CHANGES TO REGISTRATION

  • Cancellation or request for changes to conference registration, workshop registration, and registration for signature programs and special events must be made in writing and received no later than Friday, May 26, 2017. Any cancellations received after May 26 will not be refunded.
  • Refunds, if approved, may be processed four to six weeks after the conference.
  • If payment is made by credit card, a credit will be issued to your credit card account; otherwise, a refund check will be issued.
  • There are no refunds for special event registrations unless the event is sold out or canceled.
  • A $100 cancellation fee will be deducted from conference registration refunds and a $100 cancellation fee will be deducted from workshop, signature program, and special event registration refunds up to a $200 maximum deduction for multiple cancellations. Changes to a preconference workshop registration will result in a $25 change fee per workshop. If NAFSA cancels a workshop, you will receive notification of the cancellation and a full refund.
  • All requests for changes, cancellations, and refunds must be made in writing and received no later than Friday, May 26, 2017: NAFSA 2017, c/o Experient 5202 Presidents Court, Suite G100, Frederick, MD 21703 or nafsa@experient-inc.com.

20d REGISTRATION QUESTIONS? E-mail nafsa@experient-inc.com or call +1.240.439.2960.

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