Name_____________________________________________________________  

Title______________________________________________________________

Company_________________________________________________________

Address__________________________________________________________

City_________________     State________  Zip_____   Country____________

Telephone________________________     Fax_________________________

E-mail__________________________________________________________

Sponsorships   (Benefits can be found on website www.us-panama.org)      

___Gold-$10,000      ___Silver-$5,000     ___Bronze-$3,000     

___Gala, Table of 10 - $2,000    ___Lunch, Table of 8 -$750   

Sponsors have automatic attendance to the conference, all events and exhibit space.

Conference and Events

___Full registration - $1,500 (Full registration includes 4 nights at the Hotel, 

Conference, two lunches, Panama Canal Reception, gala dinner, and field trip)

___Significant Other - $250

Method of Payment (Please complete to register and for hotel reservations)

Check in the amount of $_________. 

Please make check payable to USPA and mail it to USPA, 1300 Pennsylvania Ave, NW, 

Suite G0003, Washington DC 20004.

PANAMA deliver TO: Calle Ricardo Arias, Proconsa II, Office 9D, Ciudad de Panama, 

Panama. 

Credit card in the amount of $________ .    ___ Amex       ___Visa      ___Mastercard.

CC#____________________________________________ Expiration date________  

Signature___________________________________________________________  

Hotel Reservations (Deadline for reservation April 16, 2007). 

(Only applies to international visitors).

Miramar InterContinental Hotel  

(FOR SPONSORS: Single occupancy - $150   Double room - $160. Please add 10% tax. )

(FOR INTERNATIONAL VISITORS: Full registration includes 4 nights at the hotel)

Check in ____________   Check out ___________   # of nights ____________

___Single Occupancy   ___Double Occupancy     Smoking: ___Yes   ___No    

Bed ____King ___Double 

Special requests will be accommodated if possible _____________________________

___________________________________________________________________

Flight Information

Arrival Date _________  Airline/Flight #________ 

Arrival Time _____ From____________________

Departure Date _______ Airline/Flight #_______ 

Departure Time _____To __________________

___ Require transportation from Airport to Hotel ___ Do not require

___ Require transportation from Hotel to Airport ___ Do not require 

Washington Office                                         

U.S.-Panama Business Council                                             

Ronald Reagan Building & ITC                 
                             
1300 Pennsylvania Ave., NW – Suite G0003                      

Washington, DC 20004                                                       

Tel. (301) 986-8802  Fax. (301) 986-8803                         

E-mail: Panamerica@msn.com                                             

Website: www.us-panama.org                                         

Attention: Juan Sosa / Margaret Sosa                                       

Panama Office  

Consejo Empresarial EEUU-Panamá

Apartado 87-3580, Zone 7 – World Trade Center

Calle Ricardo Arias, Edificio Proconsa II, Oficina 9D

Ciudad de Panamá, República de Panamá

Tel. (507) 269-2178   Fax. (507) 269-0534

E-mail: uspa@cableonda.net

Website: www.us-panama.org

Attention: Enrique de Obarrio / Enrique Sosa


PLEASE FAX REGISTRATION FORM TO

USPA-USA (301) 986-8803 OR USPA-PANAMA (507) 269-0534  

(General Information)
(Program)
(Expo & Registration Fees)
(Registration Form & Hotel Info.)
(Sponsorship Benefits)
(Sponsors Recognition)