Hampton University Technology Conference 2002
April 3-5, 2002
“Are You Sure, It Is Secure?”
APPLICATION TO REGISTER


Registration Form

Name Last First MI

Organization

Address Line 1

Address Line 2

City State Zip Code

Phone (office) Phone (fax)

E-mail

Registration Information:
$250.00 - Pre-registration
$100.00 - College Students (with valid ID)
$100.00 - Hampton University Faculty
Free - Hampton University Students

 

 

TOTAL AMOUNT ENCLOSED $
Certified Check
Money Order
Cashier's Check

NO PERSONAL CHECKS

Make Payable to: Hampton University Technology Conference 2002

 

Mastercard Visa American Express Discover

Account Number
Expiration Date

 

Name as it appears on card

 

 

Signature ___________________________________ Date____________________

Pre- Registration fees and form must be post marked March 15, 2002

Mail to:

Office Hours 8:00am-5:00pm
Hampton University
Center for Information Technology
Harvey Library 5th Floor
Hampton, Va 23668


For Additional Info or questions, please contact Ms. Adrienna Davis
(757)728-6927
FAX (757)727-5438
HUTC2002@hamptonu.edu :(Subject heading HUTC2002)