ONLINE REGISTRATION FORM

Developing and Using Performance Measures
in Arizona State Government
Date: October 21, 2004
Location: Phoenix, AZ

Name:

Title:

Organization:

Address:

Address (cont'd):

City:

State: Zip:

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 let us know in the "Comments" field below if you'd rather not send your 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.