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April 7-9 2000 · Logan Airport Hilton · Boston, MA


Please print this form to submit your registration
Click here for details


REGISTRATION FORM  - PRINT VERSION

Registration Fees

Members

Non-Members

 
$400 

 
$550 

Note:Items in bold are required

Title:  Mr. Ms.  

ASIS Member No.

First Name:

Last Name:

Nickname (for badge):

Position/Job Title:

Organization:

Address:

City:

State/Province:
   

Zip+4/Postal Code:
/   

Country:

Telephone:
  

Fax:
     

Electronic Mail:

Is this an address Change? Yes No 


NOTE:  Early rates are in effect until Monday, March 6, 2000.


PAYMENT INFORMATION
(All registration fees must be paid in full with the registration form)

Payment Type:

  American Express        MasterCard       Visa

 

 

 

Card Number:
 

Expires:
 

Signature: ___________________________________________
                                          


Register Now!  Send your completed form via:

      Fax:  (301) 495-0810

      Mail:

        ASIS
        SUMMIT 2000 REGISTRATION
        Dept 5189
        Washington, DC 20061-5189

      Call:  (301) 495-0900


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