Directors' Institute Application Form

Only current directors serving on boards are eligible to apply.

Please fill out and submit the following form.

Roundtable Forum		Associates of The Conference Board	Corporate Rates
	Individual - New York, NY - June 4-5, 2009	$3,500	$4,500
	Individual - Chicago, IL - Mar. 26, 2009	$2,500	$3,500
	Chicago Group Rate Allows three directors to participate in any program during the year. Note: Rate applies to Chicago program only.	$7,000	$10,000
Note: Group and Full Board access rates below apply to New York programs only.
	Group (for corporate boards) Allows three directors to participate in any program during the year.	$8,000	$12,000
	Full Board Access Allows up to eight directors to participate in any program during the year.	$20,000	$25,000
	In-House Rates Program fees are determined based on program length, the number of faculty required, and whether the company is an Associate of The Conference Board.	If you choose this option, you will be contacted by our staff to determine what your specific requirements are.
	Please click here if you are a member of the Society of Corporate Secretaries and Governance Professionals. You are eligible for Associate rates.

Note: Fields marked with an * are required.

Name:*
Title:*
Company:*
Address:*
City:*		State/ Providence:
*Zip Code:**
Tel:*	(Example: 1-212-333-3333)	Fax:
Email:*
Please list the boards on which registrant currently serves.

Cancellation Policy
Cancellation three weeks prior to meeting date — full refund granted.
Cancellation two weeks prior to meeting date — $250 administration fee.
Cancellation less than two week prior to event — no refund.

For more information, contact:
Nicole Esposito
Administrator,
Governance Center and Directors' Institute
Tel: +1 212 339 0347
Fax: +1 212 839 9711
nicole.esposito@conference-board.org