CODI Table Editor Workshop Registration
Sunday, November 6, 2005
Registration Form
All requests must be confirmed by telephone or e-mail to be validated. After receiving the information that you provide us on this form, we will attempt to contact you to confirm that we have your order and confirm payment arrangements. Your personal information will not be shared with any third party.
The workshops will be held in one of the Conference Hotels (you'll receive specific room information in advance of the conference).
First Name:
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Last Name:
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Library / Organization:
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Department:
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Address 1:
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Address 2:
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Address 3:
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City / Town:
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State / Province:
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ZIP / Postal Code:
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Country:
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E-mail Address:
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Work Telephone:
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(Enter country code first, if appropriate)
FAX Telephone:
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Payment Method
(If you choose to pay with a Credit Card via PayPal, your confirming e-mail will contain a payment link.)
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Personal/Institutional Check*
Via PayPal
* Checks must be received before November 1, 2005
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American Express has decided to decline PayPal credit card transactions that are funded with an American Express Corporate Card. As a result, any attempts to register or use an American Express Corporate Card via PayPal will be denied. Alpha-G apologizes for any inconvenience.
