[Back to IPC Bulletin Board] Please print out form and complete.

HOW TO REGISTER
Please complete the registration form below and mail it with your check payment to:
IPC, 1616 P Street, Suite 100, Washington, DC 20036, USA.
If you are paying by credit card or bank transfer, please fax to (202) 328-5133.

REGISTRATION FORM
(Please print or type)

LAST NAME:

FIRST NAME:

TITLE:

COMPANY/ORGANIZATION:

ADDRESS:

CITY:

STATE:                 POSTAL CODE:
            

COUNTRY:

TELEPHONE:

FAX:

E-MAIL:

SEMINAR FEE: 
(please check one)

Corporate: US $950 by August 26, 1998
                            US $1,050 after August 26.

Non-Corporate (government/academia):
                             US $450 by August 26, 1998
                             US $550 after August 26.

(Please indicate method of payment (hotel/travel not included):

Check enclosed (in US $ and payable to IPC.)

Bank Transfer has been sent to
IPC'S ACCOUNT #12133979, CENTURY NATIONAL
BANK, 1875 EYE STREET, NW, WASHINGTON, D.C.
20006, USA. ABA #054-0015-34
(please reference your last name.)

Credit Card (Visa or MasterCard only)

Visa           MasterCard

Expiration date:                  /          

CREDIT CARD NUMBER:

NAME ON THE CARD:

AUTHORIZED SIGNATURE:

ACCOMODATIONS (Please check one)

I will require hotel accomodations.
(Please fax the attached form directly to the Kurhaus Hotell)

I will not require hotel accommodations.

Registration fees are refundable only upon receipt of written notification by August 26, 1998. Substitution of participants is permissible with prior written notification. All cancellations will be subject to a $150 processing fee.