Gescan Electrical Distributor Automation Group: 2006 Gescan Automation Users Conference


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Agenda
Location
Registration Form
Online Registration

Online Registration Form

NOTE: All fields must be filled in, except for the non-Canada address field if you are
from Canada, and the PO# field if you are not paying by PO.

First Name:
Last Name:
Company:
Address:
Street Address:
City:
Province/State:
Postal Code:
Non-Canada Address: If you are from outside Canada, please enter your country AND postal code or zip code in the field below.

	Area Code	Number (e.g. 123-4567)
Tel:
Fax:

Email:

Registration:	Conference: Part Number - UC2006-001 ($600)
	Spouse Attendance: Part Number - UC2006-002 ($300)
	Spouse Name:

Payment:	Please select a payment method:
	If paying by Purchase Order, please enter the PO# below:

To guarantee your spot register early as space is limited. No Refunds will be issued for failure to attend without prior notice.

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