Fall 1997 Registration

Insulated Conductors Committee

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IEEE/PES Insulated Conductors Committee

Fall 1997 Meeting - St. Petersburg, FL

Complete this form, then print it and mail to the address at the bottom of the page.

[ ] Meeting Registration [ ] Address Change Only

Attendee Badge:

Last Name: ____________________________________
First Name: ________________________
Initial: ______
First name for badge: _____________

Guest name badge:

First: ________________
Last: __________________

Preferred Mailing Address:

__________________________________________________________________
__________________________________________________________________
City: _______________________
State: __________
Postal Code: ____________
Country: _________________

Phone No. ___________________
Fax No: ____________________
E-Mail ID: _____________________________

Company: ____________________________________________________________________

IEEE Member [ ] Yes [ ] No Member No: ___________________

PES Member [ ] Yes [ ] No Chapter Name: ______________________________

ICC Member Classification [ ] Guest [ ] Member [ ] Voting Member

Note: To request a change in your membership classification see the ICC membership guidelines.

IEC or other International Organization (please specify): __________________________

		Number	Each	Total US $
Advance Registration:	IEEE Member	ARM	___ @ 60.00	_______
	Non-member	ARN	___ @ 70.00	_______
On-site Registration:	IEEE Member	ORM	___ @ 70.00	_______
	Non-member	ORN	___ @ 80.00	_______
Complimentary Registration	(retired)	CR	___ @ n/c
ICC Minutes, Fall 1997 - St. Pete		FM	___ @ 30.00	_______
ICC Minutes, Spring 1997 - Scottsdale (if available)		SM	___ @ 30.00	_______
Nov 2 - Orientation Program		ONP	___ @ n/c
Nov 2 - Reception		REC	___ @ n/c
Nov 4 - Transnational Lunch		TL	___ @ 25.00	_______
Nov 4 - Gala Celebration		GALA	___ @ 30.00	_______
Nov 3 - St. Armand's Circle Tour		SCT	___ @ 20.00	_______
Nov 4 - Dali Museum Tour		DMT	___ @ 20.00	_______
Nov 5 - Educational Program (didactic)		EDU	___ @ n/c	_______
			Total Amount Enclosed U.S. $	_______

Please make checks payable in US funds to "ICC", and return this from with your payment by October 24, 1997 to the Vice Chairman:

R. A. Hartlein
Georgia Tech NEETRAC
62 Lake Mirror Road - Building 3
Forest Park, GA 30050

Return to the Fall 1997 ICC Meeting page

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