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Conference Registration Form

No registration refunds will be issued after August 1st.
Download the registration form instead.
Please enter your contact information.
Title:
*First Name:
Middle Inital:
*Last Name:
Your Job Position:
Institutional Affiliation or Employer:
*Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
Zip or Postal Code:
Country:
*Telephone:
Fax:
*Enter your preferred email:
*Re-enter Email:
Website, enter URL after http://


*Select your conference registration level:
(see fee structure at right for explanation)
Number of Registrants:
(Inst level should indicate total #)


Number of Banquet Tickets
(includes Awards Ceremony, non-refundable)
Indicate Banquet Meal Preference:
(we will try to honor it.)
Awards Ceremony Tickets
(instead of Banquet, non-refundable)
If you are purchasing registrations or banquet tickets for someone other than yourself (especially for institutional registrations), please specify their name(s) in this box. You can also indicate banquet meal preferences here.


Special Promo Code:
Today's Date:
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* denotes required field