ONLINE REGISTRATION FORM

Show Me the Measures
Date: June 17-18, 2004
Location: Ottawa, Canada

Name:

Title:

Organization:

Address:

Address (cont'd):

City:

Prov: Post:

Phone:

Fax:

E-mail:

How did you
hear about the Summit?

*REQUIRED

If you selected "brochure" or "faxed flyer," please find the
"Priority Code" written near your name on the brochure or fax
and enter it here.
Please enter that code here:

Payment Information:

	Credit Card
	Check
	Purchase Order

Credit Card Number:

Expiration:

Name on Card:

Please call me, I don't want to send my credit card information over the Internet

Comments:

Cancellations: A ten percent charge will be assessed on your conference registration fee for any cancellation within 3 weeks of the event.