World Balloon Convention Registration Form hiroka.fujinuma@pioneerballoon.com Section 1: Personal Information First Name _____________________________________________________ Last Name( )_____________________________________________________ E-mail Address E QBN CBA __________________________________________________ Company( ) _______________________________________________________ Title ___________________________________________________________ Qualatex Balloon Network Member? QBN Certified Balloon Artist? CBA Yes No Yes No E Work Address _________________________________________________ Work City ___________________________________________________ Work State/Province ____________________________________________ ZIP/Postal Code ________________________________________________ Country( ) _______________________________________________________ Work Phone 81 ________________________ Section 2: Registration Questions • How did you hear about this event? __ Balloon Images magazine Balloon Images __ Balloon Magic –The Magazine(Balloon Magic ) __ WorldBalloonConvention.com World Balloon Convention.com __ Party & Paper Retailer magazine Party & Paper Retailer __ Balloon HQ Balloon HQ __ Balloon Resource Center Balloon Resource Center __ Word of mouth __ Direct mail • How long have you been in the professional balloon business? __ Less than one year __ 1-2 years __ 2-3 years __ 3-5 years __ 5-10 years 5 10 __ 10+ years 10 • What do you hope to learn at the WBC? WBC ____________________________________________________________________ _____________________________________________________________________________________ _______________________________________________________________________ • What is your primary business type? (choose one) __ Balloon Professional __ Balloon Twister __ Party/Novelty Store / __ Party Rental __ Card or Gift Shop __ Florist __ Supermarket __ Discount Store __ Drug Store __ Craft/Hobby Store / __ Gift Baskets __ Event/Party Planner / __ Wedding Planner __ Event Site/Venue (where events are held) __ Other _________________________________________________________________ • What is your store type? (choose one) __ Independent Storefront __ Chain/Franchise Storefront / __ Warehouse (no walk-in) __ Home-based __ Web-based __ Other _________________________________________________________________ • What percentage of Qualatex balloons do you use in your business? Please list a number between 0 and 100 __________________ • What products do you currently use and/or offer? (check all that apply) __ Latex Balloons __ Foil Balloons __ Qualatex Bubble Balloons __ Entertainer/Twisting Balloons __ Personalized Balloons __ SDS Panels SDS / __ Consumer Packaged Balloons __ Balloon Twisting Kits __ Licensed Characters __ Water Balloons __ Advertising/Display Balloons / __ Playballs __ Sparkle Products __ Ribbon __ Mugs __ Other _________________________________________________________________ • What services do you currently offer? (check all that apply) __ Balloon Decorating On-site __ Balloon Decor for Pick Up __ Single Inflated Balloons for Pick Up / __ Custom Bouquets for Pick Up __ Custom Bouquets Delivered __ Balloon Twisting/Entertaining / __ Event Planning __ Gift Baskets __ Gift in a Balloon __ Other ________________________________________________________________ • Pursuant to the Americans with Disabilities Act, do you require specific aids or services? __ Visual __ Audio __ Mobile • Please indicate any special needs (accessibility, dietary, etc.). _____________________________________________________________________________________ _______________________________________________________________________ Section 3: Class Selection Please refer to the Downloadable Class Schedule at WorldBalloonConvention.com for class titles, dates, and times. Upon registration, you cannot select overlapping sessions, so please be sure to select classes only during the times when you are not already competing or taking a Qualatex plant tour. WorldBalloonConvention.com • Wednesday, April 14 4 ___ 1-5 p.m. Qualatex Fundamentals • Thursday, April 15 4 8:30-10 a.m. ________________________________________________________ 10:30-noon _________________________________________________________ 2-3:30 p.m. __________________________________________________________ 4-5:30 p.m. __________________________________________________________ • Friday, April 16 4 8:30-10 a.m. __________________________________________________________ 10:30-noon ___________________________________________________________ 1:30-3 p.m. ___________________________________________________________ 3:30-5 p.m. ___________________________________________________________ 5:30-7 p.m. ___________________________________________________________ • Saturday, April 17 4 8:30-10 a.m. __________________________________________________________ 10:30-noon ___________________________________________________________ 1:30-3 p.m. ___________________________________________________________ Section 4: Competitions and Entry Fees Competition( ) Large Sculpture Medium Sculpture Deliverable Sculpture Delivery Bouquet Table Arrangement Balloon Column Balloon Figure 4/14 4/14 4/15 4/16 4/16 4/16 4/16 Competition total 9am 4/15 12:00pm-5 p.m. 10 a.m.7:30-10:30 a.m. 7:30-10:30 a.m. 9 a.m. 1:15-1:30 p.m. $35___ $25___ $20___ $20___ $20___ $20___ $10___ ____ New Artist of the Year • • • • To qualify for New Artist of the Year, you must have been working for a professional balloon business for three years or less and participate in at least two WBC competitions of your choice. One winner will be determined based on cumulative points from both entries. WBC WBC 2010 Master Designer WBC2010 • To qualify for Master Designer, you must compete in three competitions: Large Sculpture, Table Arrangement, and your choice of Delivery Bouquet or Balloon Column. One winner will be determined based on cumulative points from all three entries. Section 5: Qualatex Plant Tour Times (select only one) April 15, 2010 4 7:30-10 a.m. 8:30-11 a.m. 9:30 a.m.-noon 10:30 a.m.-1 p.m. 11:30 a.m.-2 p.m. 12:30-3 p.m. 1:30-4 p.m. 2:30-5 p.m. 3:30-6 p.m. ___ ___ ___ ___ ___ ___ ___ ___ ___ April 16, 2010 4 4:30-7 p.m. 5:30-8 p.m. 6:30-9 p.m. ___ ___ ___ Section 6: A La Carte Tickets • A limited number of la carte event tickets are available for anyone 16 years of age or older who is not a full-package WBC delegate, but may be accompanying a full-package delegate to the WBC Opening Theme Party or WBC Grand Gala. • Before April 1, 2010 4 1 After April 1 $95 $110 ___ $65 $75 ___ A La Carte Grand Gala Ticket A La Carte Opening Theme Party Ticket • A La Carte Ticket Total • ____ Section 7: WBC Educational Handbook WBC Benefit from all of the WBC classes –even those you can’t attend –with the Educational Handbook. The Educational Handbook is a comprehensive notebook of all WBC instructors’handouts and notes. (Handouts and class notes will not be distributed in classes and are not included in the basic registration fees.) Be sure to request your copy of the handbook now. We cannot guarantee availability of extra handbooks on site. WBC WBC $30/ Educational Handbook Total ___ $____ Section 8: Optional Items • World Balloon Convention T-shirt TBlack t-shirt with full-color, screen-printed World Balloon Convention logo Heavyweight 6.1-ounce, 100% cotton T 170 100% Available in sizes: __ Small S __ Medium M __ Large L __ Extra Large XL __ 1X __ 2X __ 3X $15 $15 $15 $15 $18 $18 $18 • Women’s Polo Shirt (available in Black or Stone) Polo shirt with full-color, embroidered World Balloon Convention logo Soft pique knit is shrink-resistant and easy to care for 7-ounce, 100% ring spun combed cotton heavyweight pique (preshrunk) 198 Available in sizes: __ Extra Small XS __ Small S __ Medium M __ Large L __ Extra Large XL __ XXL __ Plus 1X __ Plus 2X 100 $25 $25 $25 $25 $25 $28 $28 $28 • Men’s Polo Shirt (available in Black or Stone) Polo shirt with full-color, embroidered World Balloon Convention logo Soft pique knit is shrink-resistant and easy to care for 7-ounce, 100% ring spun combed cotton heavyweight pique (preshrunk) 198 Available in sizes: __ Extra Small XS __ Small S __ Medium M __ Large L __ Extra Large XL __ 1X __ 2X __ 3X $25 $25 $25 $25 $25 $28 $28 $28 Optional Item Total _____ 100 Section 9: Payment Method Discount code (fill in WBC Distributor Scholarship code, if applicable) ____________________ WBC Credit Card Payment Information Name on Card ________________________________________________________________ Type Visa or MasterCard _______________________________________________________ Credit Card # _________________________________________________________________ Card Security Code ___________________________________________________________ Expiration Date _______________________________________________________________ Credit Card Billing Address (including city, state/province, ZIP/postal code, and country _____________________________________________________________________________________ _____________________________________________________________________________________ ________________________________________________________________
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