| Name: (type or print) | |||
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Company/University: | |||
| Address: | |||
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____________________________ City/State/Country/Zip |
Phone:_____/______________________
FAX: _____/______________________ Email:____________________________
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Postmarked
BEFORE February 7, 2003 |
Postmarked
AFTER February 7, 2003 |
| Advanced Registration CMP Short Course
Tuesday, February 18 |
$375 | $415 | |
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Advance Registration CMP-MIC
Wednesday thru Friday, February 19 - 21 |
$425 | $465 | |
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Cancellations received in writing after February 7th are subject to a $50 administration charge. Thereafter, no refunds. All paperwork must be RECEIVED at VMIC office by February 8th, or register at the Conference Door. | |||
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Additional copies of the '03 CMP-MIC Proceedings will be available at $110 each for conference attendees only. After the conference, mail orders add $15 plus $15 (U.S. and Canada) or $30 (foreign) per book for shipping and handling | |||
03 CMP-MIC Proceedings (specify number ________x's Cost - $110 (to be picked up at conference) |
$ | ||
| Past Year's Proceedings (specify number and years) | $ | ||
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TOTAL |
$ | ||
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Make checks payable to: '2003 IMIC and mail to: | |||
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PAYMENT METHOD (please check one)
______ Check enclosed (U. S. Funds Only) Check Number:______________________
OR Charge my: Visa _____ Mastercard _______Discover______ American Express______ Card Name:___________________________________________ Credit Card # _________________________________ Exp Date________________
Cardholder Name__________________________________________
Signature______________________________________Date________________
Phone # to call if problems with card_______________________________________
IMIC Tax I.D. # 59-3176166 (or mail / fax W9) |
CONFERENCE FISCAL POLICIES:
Checks must be in U.S. Dollars and drawn from bank account with U. S. Offices. If foreign financial instruments are used (e.g., Eurocheck), please add $75 processing fee. Cancellations: Refunds for cancellation of advance registration will be honored provided the request to cancel are made in writing and are received no later than February 7, 2003. Thereafter, no refund will be given. No telephone calls will be acceptable. All refunds for cancellation will be subject to a $50 handling charge. Refunds will be sent after the conference.Applications received without payment will not be honored as Advance Registration. Payment must be in the form of a check, money order or credit card (Visa/MC/Discover/American Express). Purchase orders NOT accepted. Registration Form and fees must be received by February 7, 2003. Receiving of payment after February 7, 2003 will require full payment again at the conference, and reimbursement of prepayment after the conference, less a $50 service charge.
Use one form per person, please (photocopies accepted). Please enclose a check (U. S. Funds only) made payable to "2003 IMIC." Or you can include your Visa / Mastercard / Discover / AMX number and fax the form to the IMIC Secretary at 813-978-3552 (on or before February 7, 2003 only, thereafter plan to register at Conference). Check, cash and credit cards (Visa/MC/Discover/American Express) accepted at Conference registration desk on-site. Pre-registered attendees may pick up their materials at on-site Conf. Registration Desk.