To Register: Complete a registration form for each person attending the meeting (no separate form needed for spouses) with payment information.

Or, mail along with a check (made out to the College of Healthcare Information Management Executives) or VISA/MasterCard/AMEX number with expiration date to:

College of Healthcare Information Management Executives (CHIME)
3300 Washtenaw Ave., Suite 225
Ann Arbor, Michigan 48104

Or, fax the form with payment information to:
(734) 665-4922

All funds must be in U.S. dollars.

NOTE:
Attendance at the CIO Forum is limited to members of the College of Healthcare Information Management Executives (CHIME) and representatives of CHIME Foundation firms. Applications for membership must be received and approved by September 28, 2009 to attend the CIO Forum. All registrations will be confirmed by email. Call the CHIME office if you do not receive written confirmation.

Meeting Fees:
EARLY BIRD DISCOUNT: Registration fees are $695 for members of CHIME. There is no charge for CHIME Foundation firm representatives (limit 4), CHIME Premier Foundation firm representatives (limit 5), and CHIME Associate Foundation representatives (limit 1), if registrations are received by Friday, July 31, 2009.

STANDARD REGISTRATION: Registration fees after July 31st and prior to September 28th, increase to $795 for members of CHIME.

AFTER CUT-OFF and ONSITE: Registration fees for CHIME members will increase to $995 if registrations or full payment is not received by September 28th. Fees for Foundation firm representatives will increase to $150 for registrations received after September 28th.

	On or before 7/31/09	Between 8/1/09 and 9/28/09	After 9/29/09 and onsite
CIO Forum (CIO Members of CHIME)	$695	$795	$995
CHIME Foundation Firm (Limits apply)	Comp	Comp	$150

**Military registration rates are available. Contact CHIME for details.

Your registration fee includes:
Badge, proceedings CD, attendance at all Forum sessions, breakfasts, lunches, receptions and the golf tournament or your choice of recreational activity. Fees do not include; hotel accommodations, golf club rentals, pre-forum workshop, or spouse recreational activities or lunches.

Cancellation Policy:
Prepaid registrants who cancel in writing on or before September 28, 2009 will receive a full refund; cancellations received after September 28th, no refunds will be issued.

Email, mail or fax cancellation to:

CHIME09 * Fall CIO Forum
College of Healthcare Information Management Executives
3300 Washtenaw Avenue, Suite 225
Ann Arbor, MI 48104
Email: saldrich@cio-chime.org
Fax: 734-665-4922

Important Registration Deadlines

July 31	Register before July 31st and register at the CHIME08 rates, and save nearly $300! The early-bird discount ends on this date.
September 21	Golf outing sign-up deadline - Sign up early!
September 25	This is the hotel room reservation cut-off date (provided there are rooms left in the CHIME block). After this date, hotel rooms are subject to availability. Make your room reservations EARLY!
September 28	Register early and save! The standard registration fee ends on this date. This is the last day to cancel your registration and receive a full refund. This date is also the cut-off for golf tournament registration. If you are applying to join CHIME, all membership information must be received and approved by this date.
September 29	After cut-off and onsite registration fees go into effect.
October 27-30	CHIME09 – Fall CIO Forum