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Marriott Newton Hotel Newton, MA. ARMED FORCES COMMUNICATIONS & ELECTRONICS ASSOCIATION. New Horizons Symposium 26/27 January 2010 REGISTRATION FORM. Name: Position: Address: State: Zip Code: Fax:. Name: Company/Organization: Address: City: Telephone: E-mail:.

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Marriott Newton Hotel

Newton, MA

ARMED FORCES COMMUNICATIONS & ELECTRONICS ASSOCIATION

New Horizons Symposium

26/27 January 2010

REGISTRATION FORM

Name:

Position:

Address:

State:

Zip Code:

Fax:

Name:

Company/Organization:

Address:

City:

Telephone:

E-mail:

MAKE CHECKS PAYABLE TO: AFCEA. REGISTRATION MUST BE COMPLETED BY JANUARY 15, 2010.

NO CANCELLATIONS ACCEPTED AFTER JANUARY 15, 2010. TELEPHONE REGISTRATION WILL NOT BE ACCEPTED.

  • I understand that the contents of the briefings are for informational purposes only and may represent the views or opinions of the individual briefers.
  • A portion of the proceeds from the Symposium may be allocated to the Lexington-Concord Chapter’s Educational Fund, a not-for-profit, tax exempt public charitable fund. A sign up sheet will be available at the Symposium Registration desk where you can provide an email address should you want to know the amount of the registration fee that may be allocated for charitable purposes.
  • An attendee list will be published and distributed to all registrants. The attendee list will include name, title, address, and telephone number. If you do not want your information to be published, please check here.

$495 ~ AFCEA Member __________

$540 ~ Non-member

$165 ~ Active Duty Military/Government Civilian

Note: Fee includes State of ESC Luncheon

Registration received after 15 January 2010 will be charged a $50 late fee.

Signature

Date

Four Easy Ways To Register

Payment Amount $ _______________

Check (made payable to AFCEA)

Credit Card:

Online: www.afceaboston.com

Mail to: AFCEA, Lexington-Concord Chapter

c/o Oasis Systems, Inc.

Attention: Claire Goulet

81 Hartwell Avenue

Lexington, MA 02421

Fax: with credit card info to 781-676-7353

E-Mail: cgoulet@oasissystems.com

MasterCard

Visa

Amex

Card Number Exp. Date

Name on Card

Signature

For more information and registration questions, visit our website: www.afceaboston.com or

Contact Claire Goulet 781-676-7344; cgoulet@oasissystems.com