REGISTRATION FORM

Print, complete and mail to:

Ms. Selma Salmons
Carrier Corporation
P.O. Box 4808
Syracuse, New York 13221
or fax the form: 315-432-7846

Questions: 315-432-7448

_____ Please check here if you would like
a brochure about Boston sent to you.



Name


Title


Additional Registrant


Additional Registrant


Spouse/Guest Name


Address


City State Zip


Phone Number Fax Number


E-Mail Address



Registration # of
People
Cost
Per Person
Total Cost
       
First Registrant __________ x $545.00 = _________
       
Additional Registrant From Same Company __________ x $350.00 = _________
       
Spouse/Guest Registrant __________ x $150.00 = _________
       
Optional "Cheers" Dinner (Saturday __________ x $50.00 = _________
       
 

TOTAL AMOUNT ENCLOSED:

= _________


_______ MasterCard _______ Visa



Card Number Expiration Month/Year



Signature



Enclosed Check Number Total Amount Enclosed




All checks payable to Carrier Global Engineering Conference
.

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