2005 Feb CMP-MIC Registration Form

CMP Planarization for ULSI Multilevel Interconnection Conference, Short Course & Exhibition
February 22 - 25, 2005 at the Fremont 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 11, 2005 Postmarked AFTER
February 11, 2005
Advance Registration CMP Short Course
Tuesday, February 22, 2005 $395 $435

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

Advance Registration CMP-MIC
Wednesday thru Friday, February 23 – 25 $445 $485

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

Cancellations received in writing after February 11 are subject to a $50 administration charge. Thereafter, no refunds. All paperwork must be RECEIVED at VMIC office by February 12, or register at the Conference Door.

Additional copies of the 2005 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 2005 Proceeding(s)
2005 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: 2005 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 2005 IMIC:

MAIL check and completed registration form to IMIC
(to arrive at IMIC Office on or before February 12, 2005)

FAX completed registration form to 813-978-3552
(credit card payments ONLY) to arrive on or before February 12, 2005

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 11, 2005. 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 11, 2005. Receiving of payment after February 11, 2005 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 "2005 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 11, 2005 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.

PDF version of this page for easier printing.

IMIC Home - Conference Home - IMIC Contact

Name: (type or print) Last First Middle Company/University:
Address:
____________________________ City/State/Country/Zip	Phone:_____/______________________ FAX: _____/______________________ Email:____________________________	Postmarked BEFORE February 11, 2005	Postmarked AFTER February 11, 2005
Advance Registration CMP Short Course Tuesday, February 22, 2005		$395	$435
(Fee includes Visual Booklet, admission to all sessions, coffee breaks and Luncheon)
Advance Registration CMP-MIC Wednesday thru Friday, February 23 – 25		$445	$485
(Fee includes Proceedings, admission to all sessions, coffee breaks and CMP Luncheon)
Cancellations received in writing after February 11 are subject to a $50 administration charge. Thereafter, no refunds. All paperwork must be RECEIVED at VMIC office by February 12, or register at the Conference Door.
Additional copies of the 2005 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 2005 Proceeding(s) 2005 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: 2005 IMIC and mail to: Dr. Thomas E. Wade, General Chairman 5316 Witham Court Tampa, Florida, 33647-1026; USA FAX: 813/978-3552