February 2004 Registration Form

CMP Planarization for ULSI Multilevel Interconnection Conference, Short Course & Exhibition'
February 23 - 26, 2004 at the Marina del Rey Marriott Hotel
ADVANCE REGISTRATION
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Name: (type or print)

(Last) First Middle

Company/University:

Address:

____________________________
City/State/Country/Zip Phone:_____/______________________
FAX: _____/______________________
Email:____________________________

Postmarked BEFORE
February 13, 2004 Postmarked AFTER
February 13, 2004
Advanced Registration CMP Short Course
Monday, February 23 $375 $415

(Fee includes Visual Booklet, admission to all sessions, coffee breaks and Luncheon)

Advance Registration CMP-MIC
Tuesday thru Thursday, February 24-26 $425 $465

(Fee includes Proceedings, admission to all sessions, coffee breaks and CMP Luncheon)

Cancellations received in writing after February 13^th are subject to a $50 administration charge. Thereafter, no refunds. All paperwork must be RECEIVED at VMIC office by February 14th, or register at the Conference Door.

Additional copies of the '04 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

Additional 2004 Proceeding(s)
04 CMP-MIC Proceedings
(specify number ________x's Cost - $110 (to be picked up at conference) $

Past Year's Proceedings (specify number and years) $

TOTAL
$

Make checks payable to: '2004 IMIC and mail to:
Dr. Thomas E. Wade, General Chairman
5316 Witham Court
Tampa, Florida, 33647-1026; USA
FAX: 813/978-3552

PAYMENT METHOD (please check one)
______ Check enclosed (U. S. Funds Only) Check Number:______________________
OR Charge my: Visa _____ Mastercard _______Discover______ American Express______
(Visa/MC/Discover/American Express ONLY for Conference registration)
Card Name:___________________________________________
Credit Card # _________________________________ Exp Date________________
Cardholder Name__________________________________________
(PLEASE PRINT LEGIBLY)
Signature______________________________________Date________________
(REQUIRED)
Phone # to call if problems with card_______________________________________
To Advance Register for 2004 IMIC:

MAIL check and completed registration form to IMIC
(to arrive at IMIC Office on or before February 14, 2004)

FAX completed registration form to 813-978-3552
(credit card payments ONLY) to arrive on or before February 14, 2004

Otherwise, plan to register at the door on-site at times indicated.

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 13, 2004. 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 13, 2004. Receiving of payment after February 13, 2004 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 "2004 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 13, 2004 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.

IMIC Home - IMIC Contact

Name: (type or print)
(Last) First Middle Company/University:
Address:
____________________________ City/State/Country/Zip	Phone:_____/______________________ FAX: _____/______________________ Email:____________________________	Postmarked BEFORE February 13, 2004	Postmarked AFTER February 13, 2004
Advanced Registration CMP Short Course Monday, February 23		$375	$415
(Fee includes Visual Booklet, admission to all sessions, coffee breaks and Luncheon)
Advance Registration CMP-MIC Tuesday thru Thursday, February 24-26		$425	$465
(Fee includes Proceedings, admission to all sessions, coffee breaks and CMP Luncheon)
Cancellations received in writing after February 13^th are subject to a $50 administration charge. Thereafter, no refunds. All paperwork must be RECEIVED at VMIC office by February 14th, or register at the Conference Door.
Additional copies of the '04 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
Additional 2004 Proceeding(s) 04 CMP-MIC Proceedings (specify number ________x's Cost - $110 (to be picked up at conference)		$
Past Year's Proceedings (specify number and years)		$
TOTAL		$
Make checks payable to: '2004 IMIC and mail to: Dr. Thomas E. Wade, General Chairman 5316 Witham Court Tampa, Florida, 33647-1026; USA FAX: 813/978-3552