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Registration Form

Tulane Engineering Forum

September 13, 2002

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:

504-899-0311

Individual Registration

General Public Registration:

$200.00 until August 7, 2002

$225.00 after August 7, 2002

Tulane Alumni Registration:

$175.00 until August 7, 2002

$200.00 after August 7, 2002

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

Concurrent Session Preference

Morning Session

A B C

Afternoon 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:_________________________________________________________________