Registration Form
American Theatre Organ Society 46th Annual Convention - 2001
Central Indiana Chapter -- Indianapolis, Indiana
Saturday, August 18, to Thursday, August 23, 2001

Please Print (or type)
ATOS Member*_______________________________

Spouse/Other_________________________________

Name(s) for Badge(s)___________________________

____________________________________________

Address______________________________________

City/State/Zip_________________________________

Phone__________________Fax__________________

E-mail_______________________________________

ATOS Chapter Name___________________________

Place my chapter name on badge: Yes___ No____

ITEM DATES NO. PRICE TOTALS

Early Registration- Adult Before 7/1 ____ @$180 = $______

Student (21 or younger)                ____ @ $90 = $______

Late Registration After 7/1              ____ @$195 = $______

Jam Session (evening) Mon. 8/20       ____ @ $5 = $______

Banquet-Adult Wed. 8/22                     ____ @ $55 = $______

Student (21 or younger)               ____ @ $35 = $______

Cincinnati Afterglow Thurs.8/23         ____ @ $85 = $______
(Limited to 240 - includes lunch and dinner)
                                                                             TOTAL $______
___ I REQUIRE WHEEL CHAIR ACCESS

Cancellations: A full refund will be made if rquest is received before July 15. From July 15-31 there will be a $25 service fee; after July 31, a $75 service fee will be charged.

____Charge My: ____Master Card ____Visa

Name on Card_____________________________

Account Number____________________________

Expiration Date_____________________________

Signature__________________________________

*Important Note: If there is no ATOS member in your household please include a separate check payable to ATOS in the amount of $30 for a one-year regular membership.

Send Completed Registration Form To:
Michael Fellenzer, Registrar
ATOS 2001
6041 Garver Road
Indianapolis, IN 46208
317-251-6443 FAX

Registration Information: fellenzer@atos.org
(E-mail Preferred) 317-251-6441

Other Convention Information:
Tim Needler, Convention Chair
5440 N. Meridian Street
Indianapolis, IN 46208
317-255-8056
317-257-7031 FAX
tneedler@concerntric.net

HYATT REGENCY INDIANAPOLIS WELCOMES
AMERICAN THEATRE ORGAN SOCIETY, INC.
AUGUST 18 – AUGUST 23
RESERVATIONS MUST BE RECEIVED BY JULY 15, 2001   

Name_______________Gold Passport #______________

Address________________________________________

City, State, ZIP__________________________________

Telephone #  ___________________________________

Sharing Room With______________________________

Arrival Date _____ Arrival Time _____ Departure Date _____

A deposit of first night’s room and tax for each room must accompany this request (check, money order or credit card) in order to guarantee the reservation. All deposits are fully refundable if the room is cancelled 24 hours or more prior to the arrival date. Room rate does not include 11% tax.  To guarantee convention rates, this form must be received by July 15, 2001. 

Mail This Form To:
      HYATT REGENCY INDIANAPOLIS
      One South Capitol Avenue
      Indianapolis, IN  46204
      317-632-1234 • 317-616-6299 FAX   

Please check preferred accommodations.
All rooms subject to 11% tax.
  £$89 Single (King Bed, 1 or 2 people)
  £$89 Double (2 Double Beds, 2 people)
  £$103 Triple (2 Double Beds, 3 people)
  £$118 Quad (2 Double Beds, 4 people)

Card # ____________________________

Name on Card _____________________ 
   
Signature _________________________

Expiration Date_____________________

      £ VISA               £ MasterCard    
      £ Discover          £ Am. Express