FASUG Tuesday October 23th 2007 ADD Registration Form

Please print or type. Please make additional copies for each person.

* Registration Information

Last Name ____________________________ First Name ________________________

Company ________________________________________________________________

Address _________________________________________________________________

City ___________________________________ State _____ Zip Code _________

Phone # (_____) ______________________ Fax # (_____) ___________________

Email ________________________________

Please check the box for each session you plan to attend. See the Session/Agenda for session names and content. This will allow us to put the presentations into the proper sized rooms. You can attend sessions from any track.

Session Track A Track B Track C Track D
1                    
2                    
3                    
4                    
5                    

* Conference Fee:

If payment is received prior to Oct 9th, you are entitled to the early bird discount payment. If after Oct 9th, or paying at the door the day of the conference, the total cost per individual is $275. Please understand that we mean payment, and not just registration.

Early Bird Payment - $225 __________ Regular Payment & Registration $275 ______________ 


      (___) Payment Enclosed       (___)Will pay at the door (No early bird discount)

Total Amount Due: _____________ Make Checks Payable to FASUG
* Payment Information:

Please indicate form of payment. Payment must be included with this form, unless you are paying at the door. You will not be entitled to the early bird registration if paying at the door.

If you are paying at the door, please fax this registration back to (203)790-6056, so we know how many handouts to make.

* Cancellation Policy

Cancellations received in writing (mailed or faxed) no later than October 3rd, will be refunded in full. No refunds for cancellations received within two weeks of the event. Those who register and indicate that they will pay at the door, must adhere to the cancellation policy, otherwise they will be invoiced.

How to register in advance: 


Mail: FASUG
      36 Mill Plain Rd., Suite 304
      Danbury, CT 06811
      Fax:   (203) 790-6056
      Phone: (203) 744-7854  Ext 10
Signature ____________________________________________________