Tulane Engineering Registration Form
Registration Form
Tulane Engineering Forum
September 21, 2001
School of Engineering, Tulane University
Registration Information
To register, please complete the information below,
print the form and mail to:
Jenny Kottler
Tulane University
School of Engineering
105 Sycamore Dr.
Metairie, LA 70005
If paying by VISA/Mastercard,
print the form and fax to:
504-835-1401
Individual Registration
General Public Registration:
$200.00 until August 20, 2001
$225.00 after August 20, 2001
Tulane Alumni Registration:
$175.00 until August 20, 2001
$200.00 after August 20, 2001
Graduation Year
Corporate Registration
$1,000.00 Corporate Sponsor
Admits: 4 guests to the sessions, one couple to speakers' reception,
and company recognition in program literature.
$2,500.00 Forum Sponsor
Admits: 10 guests to the sessions, one couple to speakers' reception,
and logo recognition in program literature.
$5,000.00 Forum Patron
Admits: 10 guests to the sessions, one couple to speakers' reception,
logo recognition in program literature, and recognition as host of closing reception.
$10,000.00 Forum Underwriter
Admits: 10 guests to the sessions, one couple to speakers' reception,
logo recognition in program literature, and recognition as host of Forum lunch.
Title
First Name
MI
Last Name
Company/University
Address 1
Address 2
City
State
Zip
Contact Phone
Fax
Your E-mail
Breakout Session Preference
Morning Concurrent Breakout Session
A
B
C
Afternoon Concurrent Breakout Session
D
E
F
Payment:
Number of Tickets
Ticket Price $
Total $
Check payable to "Tulane School of Engineering"
VISA/Mastercard
VISA/Master Card Number
Expiration(Month/Year)
Card Holder Name
Signature:____________________________________________________________
Date:_________________________________________________________________