Registration Form
This form is NOT INTERACTIVE. Please print, fill out, and fax, mail,
or email to the Engineering Professional Development Office at
520-621-3054.
Please register early and thereby help with planning.
Contact Information
Name:_______________________________________
Affiliation:________________________________
Address:____________________________________
City:_______________________________________
State:______________________________________
Country:____________________________________
Postal Code:________________________________
Fax:________________________________________
Email:______________________________________
Accomodations and AV
Each meeting room will be supplied with overhead projector, screen, pointer,
and microphone if necessary. Slide projectors will also be available upon
request. Costs for requests for extraordinary AV support will be charged to
the presenter.
COSTS
Through October 1, 1997. Late Registration after 10/1/97 is
$50 more across all categories.
................Members..........Non-Members
Per Person:.....$100.............$140
Students/
Underemployed....$50.............$75
Optional Renewal of 4S membership:
.................$30/15
For non-member program participants a portion of the registration will go
toward a 4S membership.
Optional Meals:
Banquet: __________$22.00
Friday Brown
Bag Lunch: ________$ 7.50
Saturday. Brown
Bag Lunch: ________$ 7.50
Total Enclosed: _________
Please make checks payable to the University of Arizona
Foundation. Registrations fees are not a tax deductible
contribution. However, they may be a business expense. Please check
with your accountant or tax advisor.
If you wish to use your Visa or Mastercard:
Card No.:_____________________________________ Exp. Date:__________
Signature:____________________________________
The University of Arizona accepts American Express:
Card No.:_____________________________________ Exp. Date:__________
Signature:____________________________________
Mail/Fax or Email this form to:
Engineering Professional Development
The University of Arizona
1224 N. Vine Avenue, Tucson, AZ 85719-4552
Phone: 520-621-3054
Fax: 520-621-1443
Email: epd@bigdog.engr.arizona.edu
Website
Return