Conference Registration

Please print out the Registration Form. Complete the form and fax or mail it to us.

Mr./ Ms./ Dr. First Name: _______________________ Last Name: _______________________

Title: _______________________________________

Company: ___________________________________

Address: _________________________________________________ Mailstop: _____________

City: ______________________ State: ______ Zip Code: __________ Country: _____________

Telephone: __________________________________

Fax: _______________________________________

E-mail Address: ______________________________

URL: ______________________________________ (if applicable)

Payment Method

For credit card payment:
Please print out the Registration Form. Complete the form and fax or mail it to us. Credit card information will not be accepted over the Internet. Payment must be received with Registration Form.

Please select the credit card you wish you use:

___ Visa ___ Mastercard ___ American Express ___ Diners Club

Credit Card Number: _____________________________

Expiration Date (e.g. 08/97): ____/____

Name of Cardholder: _____________________________

Travel and Accommodations

Discounted airline, hotel and rental car packages are available in conjuction with the conference.

___ No, I am not interested

Or call (800) 488-2883 for more information

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Cancellation, Substitutions and Refunds

There is a cancellation fee of 20% for all paid registrations. We must receive a written cancellation notice no later than May 17, 1996 to issue a refund less the 20% cancellation fee. No full refunds will be issued. There are no refunds given for "no shows".

Substitutions are allowed only with the written permission of the original registrant before the registration package begins.

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