Team Registration for the 2002 Satellite Internet Forum

Please Read the Terms and Conditions of Registration.

--- Special Early Bird Rates ---
Number of Attendees:	1	2	3	4+
1 Workshop Only	$545	$545	$545	$545
2 Workshops Only	$990	$990	$990	$990
Conference Only	$1,595	$1,495	$1,395	$1,295
Conference + 1 Workshop	$1,990	$1,890	$1,790	$1,690
Conference + 2 Workshops	$2,290	$2,190	$2,090	$1,990
Rates are per each attendee * Team Rates only apply when all members register together

Attendee 1 -- Contact Information

Name

Job Title

Company

Address

City

State

Zip

Country

Telephone

Fax

E-mail

I do not wish to have my email address released
to other delegates or ACT Conferences'
Marketing Partners

Do you have any special dietary requirements?
(e.g. vegetarian, kosher, allergies?)
No Yes
If yes, please specify:

Do you require any special physical accommodations?
No Yes
If yes, please specify:

Please select the sessions which this person will be attending:

Monday December 2	Tuesday December 3	Wednesday December 4
Workshop A:	Satellite Internet Forum 2002
Workshop B:	Satellite Internet Forum 2002

Credit Card Type:	American Express	MasterCard	Visa
Credit Card Number:
Expiration Date:
Name on Card:

Attendee 2 -- Contact Information

Name

Job Title

Company

Address

City

State

Zip

Country

Telephone

Fax

E-mail

   I do not wish to have my email address released
       to other delegates or ACT Conferences'
      Marketing Partners

Do you have any special dietary requirements?
(e.g. vegetarian, kosher, allergies?)
No Yes
If yes, please specify:

Do you require any special physical accommodations?
No Yes
If yes, please specify:

Please select the sessions which this person will be attending:

Monday December 2	Tuesday December 3	Wednesday December 4
Workshop A:	Satellite Internet Forum 2002
Workshop B:	Satellite Internet Forum 2002

Credit Card Type:	American Express	MasterCard	Visa
Credit Card Number:
Expiration Date:
Name on Card:

Attendee 3 -- Contact Information

Name

Job Title

Company

Address

City

State

Zip

Country

Telephone

Fax

E-mail

I do not wish to have my email address released
to other delegates or ACT Conferences'
Marketing Partners

Do you have any special dietary requirements?
(e.g. vegetarian, kosher, allergies?)
No Yes
If yes, please specify:

Do you require any special physical accommodations?
No Yes
If yes, please specify:

Please select the sessions which this person will be attending:

Monday June 17	Tuesday June 18	Wednesday June 19
Workshop A:	Satellite Internet Forum 2002
Workshop B:	Satellite Internet Forum 2002

Credit Card Type:	American Express	MasterCard	Visa
Credit Card Number:
Expiration Date:
Name on Card:

Attendee 4 -- Contact Information

Name

Job Title

Company

Address

City

State

Zip

Country

Telephone

Fax

E-mail

I do not wish to have my email address released
to other delegates or ACT Conferences'
Marketing Partners

Do you have any special dietary requirements?
(e.g. vegetarian, kosher, allergies?)
No Yes
If yes, please specify:

Do you require any special physical accommodations?
No Yes
If yes, please specify:

Please select the sessions which this person will be attending:

Monday December 2	Tuesday December 3	Wednesday December 4
Workshop A:	Satellite Internet Forum 2002
Workshop B:	Satellite Internet Forum 2002

Credit Card Type:	American Express	MasterCard	Visa
Credit Card Number:
Expiration Date:
Name on Card:

If you are not one of the people listed above, but you are the best person for us to contact should we have any questions regarding these registrations, please provide us with your contact information:

Name
Job Title
Telephone	Fax
E-mail
Also, please include any notes or comments here:

* How did you, or your organization, *
* hear about this event? *

Please Read the
Terms and Conditions of Registration.

If you have any problems with this form, please contact us,
so that we may fix the problem, and assist you
in the registration process.

Phone: 417-883-7755

E-mail: melina@actconferences.com