EmailMe Form - Southwestern Section IMSA - November 2021

Southwestern Section IMSA - November 2021

FALL CONFERENCE & CERTIFICATION PROGRAM
NOVEMBER 15-18, 2021

DEADLINE FOR REGISTRATION: October 8, 2021

GREAT WOLF LODGE
100 Great Wolf Drive, Grapevine, TX 76051
1-844-554-9653
Use Code: IMSA2021 for guaranteed room rate of $123.00
Deadline to reserve room is October 25, 2020

INDIVIDUAL RESERVATIONS:
Each individual guest must make their own reservations by calling the toll-free Central Reservations Department at 1-888-554-9653 by 10/25/2021. They must identify themselves as members of the group, with RESERVATION #IMSA2021. All reservations must be guaranteed by the individual and accompanied by a first night room deposit or guaranteed with a major credit card. Each individual has up to 72 hours prior to arrival to cancel the individual room with a $40.00 cancellation fee per room. If the individual cancels the room within 72 hours of arrival date, 100% of the first nights room rate plus tax will be charged to the individual’s credit card or taken from the deposit. *
By checking this box I understand, acknowledge, and agree to the paragraph above concerning Great Wolf Lodge's Reservation Cancellation Policy
Name *
First Last
Member #,if not a member Please put in "1" *
Phone *
### - ### - ####
Employer *
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *
Registration *
New Registration
Renewal Registration (No Exam)
Challenge Exam
Exam Retake
Level III Review
TRAFFIC SIGNAL TECHNICIAN LEVEL I
MON 11/15/21 - TUES 11/16/21
8:00am - 5:00pm
New Registration: Course, Manual, Material, Exam, 2 lunches
Renewal: Course, Material, 2 Lunches
NEW REGISTRATION: MEMBER $560.00
NEW REGISTRATION: N0N-MEMBER $660.00
RENEWAL: MEMBER $415.00
RENEWAL: NON-MEMBER $515.00
TRAFFIC SIGNAL TECHNICIAN LEVEL II
WED 11/17/21 - THURS 11/18/21
8:00am - 5:00pm
New Registration: Course, Manual, Material, Exam, 2 lunches
Renewal: Course, Material, 2 Lunches
NEW REGISTRATION: MEMBER $620.00
NEW REGISTRATION: N0N-MEMBER $720.00
RENEWAL: MEMBER $475.00
RENEWAL: NON-MEMBER $575.00
TRAFFIC SIGNAL INSPECTOR
MON 11/15/21 - TUES 11/16/21
8:00am - 5:00pm
New Registration: Course, Manual, Material, Exam, 2 lunches
Renewal: Course, Material, 2 Lunches
NEW REGISTRATION: MEMBER $560.00
NEW REGISTRATION: N0N-MEMBER $660.00
RENEWAL: MEMBER $415.00
RENEWAL: NON-MEMBER $515.00
TRAFFIC SIGNAL INSPECTION FOR ADVANCED TECHNOLOGIES
WED 11/17/21 - THURS 11/18/21
8:00am - 5:00pm
New Registration: Course, Manual, Material, Exam, 2 lunches
Renewal: Course, Material, 2 Lunches
NEW REGISTRATION: MEMBER $620.00
NEW REGISTRATION: N0N-MEMBER $720.00
RENEWAL: MEMBER $475.00
RENEWAL: NON-MEMBER $575.00
SIGNS & MARKINGS TECHNICIAN LEVEL I
MON 11/15/21 - TUES 11/16/21
8:00am - 5:00pm
New Registration: Course, Manual, Material, Exam, 2 lunches
Renewal: Course, Material, 2 Lunches
NEW REGISTRATION: MEMBER $560.00
NEW REGISTRATION: N0N-MEMBER $660.00
RENEWAL: MEMBER $415.00
RENEWAL: NON-MEMBER $515.00
SIGNS TECHNICIAN LEVEL II
WED 11/17/21 - THURS 11/18/21
8:00am - 5:00pm
New Registration: Course, Manual, Material, Exam, 2 lunches
Renewal: Course, Material, 2 Lunches
NEW REGISTRATION: MEMBER $620.00
NEW REGISTRATION: N0N-MEMBER $720.00
RENEWAL: MEMBER $475.00
RENEWAL: NON-MEMBER $575.00
ROADWAY LIGHTING TECHNICIAN LEVEL I
MON 11/15/21 - TUES 11/16/21
8:00am - 5:00pm
New Registration: Course, Manual, Material, Exam, 2 lunches
Renewal: Course, Material, 2 Lunches
NEW REGISTRATION: MEMBER $560.00
NEW REGISTRATION: N0N-MEMBER $660.00
RENEWAL: MEMBER $415.00
RENEWAL: NON-MEMBER $515.00
ROADWAY LIGHTING TECHNICIAN LEVEL II
WED 11/17/21 - THURS 11/18/21
8:00am - 5:00pm
New Registration: Course, Manual, Material, Exam, 2 lunches
Renewal: Course, Material, 2 Lunches
NEW REGISTRATION: MEMBER $620.00
NEW REGISTRATION: N0N-MEMBER $720.00
RENEWAL: MEMBER $475.00
RENEWAL: NON-MEMBER $575.00
CTC TROUBLESHOOTING CLASS
8:00am - 5:00pm
Course, Material, 2 Lunches

MAXIMUM OF 10 STUDENTS PER SESSION
SESSION #1 - MONDAY - TUESDAY: $405.00
CHALLENGE EXAMS / RETAKES
TUESDAY 11/16/21 OR THURSDAY 11/18/20
8:00am - 12:00pm ONLY
MEMBER $170.00 per test
NON-MEMBER $240.00 per test
EXAM RE-TEST
PLEASE CHOOSE WHICH DAY YOU WANT TO TEST FOR CHALLENGE EXAMS/RE-TESTS:
(Please Note: Due to testing having to be approved by IMSA International, you must test on the day you choose.)
TUESDAY - 11/16/21
THURSDAY - 11/18/21
WHICH EXAM ARE YOU CHALLENGING OR RE-TAKING?
WHICH EXAM ARE YOU CHALLENGING OR RE-TAKING?
Comments
Any cancellations must be submitted by October 31, 2021.
NO REFUNDS will be given after October 31, 2021.

ALL invoices shall be paid prior to the Course date.
No students will be admitted to the class if the invoice has not been paid. *
By checking this box I understand, acknowledge, and agree to the statements above concerning payments, cancellations, & refunds.
By clicking Submit below, you are acknowledging that an inherent risk of exposure to COVID-19 exists in any public place where people are present. By attending the Southwestern Section IMSA's Fall Conference, you and any guests voluntarily assume all risks related to exposure to COVID-19 and agree not to hold Southwestern Section IMSA; IMSA International; Great Wolf Lodge; or any of their affiliates, directors, officers, employees, agents, contractors, or volunteers liable for any illness or injury. *
By checking this box I understand, acknowledge, and agree to the paragraph above concerning COVID-19.