Transcription of 2018 REGISTRATION FEES
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2018 REGISTRATION FEES
Complete the following. Please print clearly to ensure correct spelling on your name is o Male o Female o Mr. o Mrs. o Ms. o Name_____ Middle Initial _____Name Preferred on Badge ( first name only) _____Last/Surname _____Job Title _____Date of Birth (optional) _____ Month Day YearInformation below is o New Address o Alternate AddressEmployer/Company/Institution _____Company Address _____ Street _____City State/Province_____ Zip/Postal Code Country Professional Area (check only one):100 o Academia101 o Government102 o Industry103 o OtherCancellation/Refund PolicyRegistration cancellations must be made in writing and received no later than June 25, 2018 and are subject to a $75 processing fee; ticketed events will be fully refunded. REGISTRATION and ticketed event cancellations received after June 25, 2018, are NOT subject to a refund.
Complete the following. Please print clearly to ensure correct spelling on your name badge. Registrant is o Male o Female o Mr. o Mrs. o Ms. o Dr. First Name_____ Middle Initial _____
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