WORLD AGRICULTURAL FORUM
2001 WORLD CONGRESS
Registration / Hotel Form
May 20-22, 2001

Please print this form, fill out completely

If you are using your passport as proof of citizenship, please indicate name as it appears on passport.

PRIMARY ATTENDEE:

Title: ____________________________________________________________________

Family Name: ____________________________________________________________

First Name: ______________________________________________________________

Name for Badge: __________________________________________________________

ADDRESS (Please provide the address where you would like to receive documentation. We would prefer no PO Boxes.)

Company Name / County Affiliation: ___________________________________________

Title/Position: ___________________________________________________________

Street Address: ___________________________________________________________

_________________________________________________________________________

City: __________________________ State: ____________ Country: ________________

ZIP or Postal Code: ________________________________________________________

TELEPHONE INFORMATION (Please include country code and city area code.)

Primary Phone (Business or Home): ___________________________________________

Secondary Phone (Business or Home): _________________________________________

Fax No.: __________________________________________________________________

Email Address: ____________________________________________________________

PASSPORT INFORMATION

Passport Holder: ___________________________________________________________

Passport Number: ________________________ Exp. Date: ________________________

Country of Issuance: _________________ Date of Birth (Day/Month /Year): _______________

Spouse or Guest

Title: ____________________________________________________________________

Family Name: _____________________________________________________________

First Name: _______________________________________________________________

Name for Badge: ___________________________________________________________

Passport Information for Spouse or Guest

Passport Holder: ___________________________________________________________

Passport Number: ________________________ Exp. Date: ________________________

Country of Issuance: _________________ Date of Birth (Day/Month /Year): ___________

Guest Activities

Additional Guests

HOTEL INFORMATION - HYATT REGENCY UNION STATION
All conference hotel reservations must be booked through AAA Travel

Arrival Date at Hotel: ______________ Departure Date from Hotel: __________________

Hyatt Gold Passport Number: ________________________________________________

Guaranteed Reservation Information:

Authorized Amount: ________________________________________________________

Credit Card Number:____________________________________ Exp. Date: ____/_____

Name on Credit Card: ______________________________________________________

Any special room requirements or requests:_____________________________________

_________________________________________________________________________

PERSONAL CONSIDERATIONS

If yes, what would you like to do: ____________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

CONGRESS REGISTRATION

The registration fee for the World Agricultural Forum 2001 Congress is $1200.00 for general participants and $600.00 for academics and NGO's when registration forms are postmarked April 9, 2001 or before. After April 9, registration fees are $1800.00 for general participants and $900.00 for academics and NGO's. Register early, space is limited. Please fax, mail or email your registration form to this address:

World Agricultural Forum
Attn: Susan Connor
12901 North Forty Drive
St. Louis, MO 63141
U.S.A.

A check payable to the AAA Travel, in U.S. dollars, or credit card payment will be acceptable for your registration fee.

Authorized Amount: ________________________________________________________

Credit Card Number: ____________________________________ Exp. Date: ____/_____

Name on Credit Card: ______________________________________________________

For questions regarding the 2001 Congress, call (001)1.314.206.3205.

RESPONSIBILITY: Notice is hereby given that the entire program herein are conducted by AAA of Missouri, which acts solely in the capacity of an agent for World Agricultural Forum in regards to travel, whether by railroad, motorcar, motorcoach, boat or airplane, and assumes no liability of injury, damage, loss, accident, delay or irregularity which may be occasioned either by reason of defect in any vehicle of any company or person engaged in conveying the passengers or in carrying out the arrangements of the tour, or otherwise in connection therewith, or of any hotel proprietor, or employee. No carrier shall have or incur any responsibility or liability as a common carrier. The airlines concerned are not to be held responsible for any act, omission or event, during the time the passenger is not on board his plane, or conveyance. The passenger contract in use by carriers concerned, when issued shall constitute the sole contract between the airlines and the purchaser of these tours and/or passengers of the tour operators. Aforesaid tour operators can accept no responsibility for losses or additional expenses due to delay or change in schedules, weather, strikes, war, quarantine or other causes. All such losses or expenses will have to be borne by the passenger. All rates shown on this program are based upon current tariffs and are subject to adjustments in the event of changes therein, at the time of final payment. Baggage is at the ownerís risk throughout the tour, unless insured. Small articles (coats, umbrellas, etc) are entirely under the care of the passenger. The liability of the carriers for baggage or other property accompanying the passenger is limited to their liability as a common carrier. The right is reserved to decline, accept, or retain any person as a member of any tour, or to cancel or alter any tour. No refund will be made for voluntary absence from any tour unless arrangements are made at time of booking.

AIR

Would you like AAA Travel to make your flight arrangements?

Your preferred Airline: ______________________________________________________

Name of Departure Airport: __________________________________________________

Departure City and Date: ___________________________________________________

Return City and Date: ______________________________________________________

Frequent Flyer Information

Because of pre-arranged flights, use of the frequent flyer airline of your choice may incur an additional cost. If you wish to use your frequent flyer airline, please complete the information below. NOTE: The airline will honor your Frequent Flyer Certificate and grant mileage only if the name on the certificate matches the name on your airline ticket exactly. If your name on your frequent flyer membership differs from your ticket, keep your boarding passes and the passenger receipt copy of your airline tickets. You will then need to apply for mileage directly with the airlines.

Participant Frequent Flyer Airline: __________________ Member #: _______________

Spouse/Guest Frequent Flyer Airline: _______________ Member #: _______________

Hertz Rental Car

Type of car

Hertz Gold Club Number: ___________________________________________________

Type of Limousine / Car: ____________________________________________________