Online Workshop Registration

Personal Information:

Last Name: First Name:

Organization:

First Name for badge:

Business Contact Information:

Email Address:

Address 1:

Address 2:

City:

State:

Postal Code:

Country:

Phone Number:

Fax Number:

Other Information:

Special Needs:
(wheel chair, special diet, etc)

Participation:

I will be a presenter at the workshop

Workshop Attendance:
All days and functions

If not attending "All days and functions", please select
the individual events that you plan to attend below:

Welcome Reception - Tuesday November 30

Technical Session - Wednesday December 1

Workshop Dinner - Wednesday December 1

Technical Session - Thursday December 2

Registration Fees

Early Bird Registration (until November 1, 2010 ) $350.00

Regular Registration (after November 2, 2010 ) $400.00

Student Registration $99.00

Payment Method:
Credit Card

Check/Mail

Other:

Please make a selection.

You will receive an email confirmation within 5 days

Please email all questions to: Jan Tucker

Mail checks to:

CRC
3650 Mansell Road, Suite 140
Alpharetta, GA 30022

Refunds will be granted if CRC receives a written request no later than November 17, 2010.
A $25.00 processing fee will be assessed for each refund.
No refunds will be granted for no-shows at the conference.