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2015 TOSHIBA CONNECT REGISTRATION
April 26 - May 1, 2015

Please use this form to register for the event. When you are finished, click the Submit button located at the bottom of the form. Press the "Back" button on your browser to discard your changes or return to the previous page.

The fields indicated with an asterisk (*) are required to complete this transaction; other fields are optional. If you do not want to provide us with the required information, please use the "Back" button on your browser to return to the previous page, or close the window or browser session that is displaying this page.

Attendee Information
Attendee Type:*
First Name:*
Last Name:*
Company:*
Job Responsibility / Title:
Business Address Line 1:*
Business Address Line 2:
Business Address Line 3:
City:*
State / Province:*
Zip / Postal Code:*
Country:*
Telephone:*
Tie Line:
E-mail:*
Company-specific email must be provided. Please no third party emails such as Gmail or Hotmail
Are you an employee of a Government Owned Entity?*
Please enter Other type:
Are you a Lobbyist?*
If yes, check all that apply:


Badge Information
Your name as indicated below will appear on your badge and roster. If you wish to change any information, please do so in the appropriate place.
First Name:
Last Name:

Hotel Information
  • Hotel accommodations will be secured for you by Toshiba based on the information below.
  • Please do not contact the hotel directly regarding your room reservation.
  • Use the "Comments" section below to communicate any special requirements to the Toshiba meeting planners.
  • Daily room rate at the conference hotel: US $189.00/night (plus applicable taxes/service fees)
Is a hotel room required?*
Hotel Name:Gaylord Opryland Resort & Convention Center, 2800 Opryland Drive, Nashville
Hotel Check-in:*
Hotel Check-out:*
Comments:
Special Dietary Requirements:

Enrollments received after Friday, March 31, 2015 cannot be guaranteed a room at the conference hotel.

*** The Gaylord Opryland may accommodate reservation requests for early arrival and extended departure dates at the Toshiba negotiated room rate, based on availability. For extended stay reservations or questions concerning your reservation, please contact: [email protected]

In order to secure a hotel room, you will be required to enter credit card information.

In the event you cancel less than 72 hours in advance, a no-show fee will be charged by the Gaylord Opryland Hotel.

Registration Information
Your registration fees include meeting materials and food/beverage for all schedule events. Travel and hotel expenses are the responsibility of the attendees. Registration fees do not include entry into Focus Group, additional fees apply.

$595 per person by February 27, 2015
$649 per person after February 27, 2015
$695 per person for registration on site

All cancellations must be received in writing to [email protected]. A complete refund of tuition fees will be issued if received by March 31, 2015; however, replacements for registrants may be made at any time without penalty.

Below is the tuition charges you will incur:
Registration Fee:$695

Focus Group Registration
Focus Group Selection:*
All cancellations must be received in writing to [email protected]. A complete refund of tuition fees will be issued if received by March 31, 2015; however, replacements for registrants may be made at any time without penalty.

Spouse Attending Reception
Spouse fee to attend Tuesday, April 28th Reception:  $100 per person
Spouse Attending Reception:*
Spouse First Name:
Spouse Last Name:

*** Please note:
  • We will be unable to process a refund should your spouse be unable to attend.
  • Fee is for reception only - other meals are for Toshiba Connect attendees only.
Financial Information
Card Type:*
Card Number:*
Card Identification Number:*
Need help?
Expiration Date:* /
Name on Card:*
PLEASE NOTE:  If paying by credit card, the tuition charges on your credit card statement will appear from Omnience, the registration company handling the conference billing on behalf of Toshiba Connect.  Hotel charges will be handled separately by the Gaylord Opryland Hotel.  You will receive an email receipt once the credit card transaction has been processed.  All payments are required to be processed prior to the start of the conference.

Emergency Contact Information
Contact Name:
Relationship:
Daytime Phone:
Evening Phone:

Notice and Choice Statement
Data entered may be used by Toshiba to provide you with information about other offerings. If you prefer not to receive such information by any means, please check box.

As an attendee, you are participating in sessions at which Toshiba may present confidential information related to development activity for Toshiba hardware, software and services.  You agree to hold all such information at these sessions in trust and confidence for a period of two years from the date of disclosure and if applicable, will limit the dissemination of this information within your organization to personnel who have a “need to know”.  This restriction shall not apply to information previously known to the attendee, rightfully acquired from third parties, independently developed, or subsequently publicly disclosed by Toshiba.

Be aware that Toshiba does not wish to receive from the attendee, and the attendee agrees not to disclose to Toshiba or its representatives, any internal or restricted information.  Accordingly, all information received from the attendee by Toshiba or its associated companies' representatives at these sessions shall be deemed to be in the public domain.

By clicking "Submit" you agree to the terms and conditions set forth above.

If you have questions about this form, please email [email protected].


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