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ON-LINE REGISTRATION

Registration Fee: $175 if registration received on or before April 26, 1999. After this date, the regular registration fee of $195 will be assessed, depending on space availability.

Please complete all parts of this registration form. If a particular field does not apply, please type "NA" in that field.


Last Name:
First Name:
Organization:
Title:
Address:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Telephone:
Fax:
Email:
Please Charge $ on my Mastercard  Visa
Credit Card Number:
Expiration Date:
Name of Cardholder:

                                 

(Please read the notes below before submitting this registration form)
Help with this Form:
If you receive a "Form Error" message, please hit the "Back" button on your browser to return to this page and then make sure you fill in all appropriate parts of the registration form. For any other problems or questions regarding the submission of this form, please email Li Eckert.

Cancellation:
Requests for cancellation received between April 30, 1999 and May 14, 1999 will be charged a $45 processing fee. Cancellation refunds will not be available on or after May 15, 1999. Substitutions of participants can be made at any time up to and including the day of the conference.

Waiver of Liability:
The submission of this registration form in consideration of registering to the Economic Development Administration Southwestern Regional Annual Conference: Technology Communities Competing in the New Millennium, holds harmless and discharges The University of Texas at Austin, other co-sponsors, management, staff, and their agents, from any actions, claims, and demands which may arise out of an accident, casualty, or occurrence growing out of participation in this program.


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