REGISTRATION

Please complete the following form. Form fields marked with an asterisk (*) are required.

Registration for the Collaborative Systems Engineering and Design Symposium is $150.

First Name*
Last Name*
Badge Name (if different)
Organization*
Street Address 1*
Street Address 2
City*
State/Province*
Zip/Postal Code*
Business Phone*
Business Fax*
E-mail Address*

Special Events*

Please let us know which of the Special Events you plan to attend. (Select all that apply)

	Complimentary Phoenix Integration Training Session
	Cocktail Reception, Hosted by Phoenix Integration
	I will not be attending either Special Event

Payment Method*

Please select one and the Event Coordinator will contact you.

	Paying by Check (or Government Purchase Order)
	Paying by Credit Card