ARMED FORCES COMMUNICATIONS & ELECTRONICS ASSOCIATION

New Horizons Symposium

27-28 January 2009

REGISTRATION FORM

Marriott Newton Hotel Newton, MA

Name: Company/Organization: Address: City: Telephone: E-mail: Name: Position: Address: State: Zip Code: Fax:

MAKE CHECKS PAYABLE TO: AFCEA. REGISTRATION MUST BE COMPLETED BY JANUARY 16, 2009.

NO CANCELLATIONS ACCEPTED AFTER JANUARY 16, 2009. TELEPHONE REGISTRATION WILL NOT BE ACCEPTED.

$495 ~ AFCEA Member __________ $540 ~ Non-member $165 ~ Active Duty Military/Government Civilian

Registration received after 16 January 2009 will be charged a $50 late fee.

Note: Fee includes State of ESC Luncheon

• I understand that the contents of the briefings are for informational purposes only and may represent the views or opinions of the individual briefers.

• A portion of the proceeds from the Symposium may be allocated to the Lexington Concord Chapter’s Educational Fund, a not-for-profit, tax exempt public charitable fund. A sign up sheet will be available at the Symposium Registration desk where you can provide an email address should you want to know the amount of the registration fee that may be allocated for charitable purposes.

• An attendee list will be published and distributed to all registrants. The attendee list will include name, title, address, and telephone number.

information to be published, please check here.

If you do not want your Signature

Payment Amount $ _______________ Check (made payable to AFCEA) Credit Card:

MasterCard Visa Amex

Card Number Exp. Date Name on Card Signature

Date

Four Easy Ways To Register

Online: Mail to: Fax: E-Mail:

www.afceaboston.com

AFCEA, Lexington-Concord Chapter c/o Oasis Systems, Inc.

Attention: Claire Goulet 81 Hartwell Avenue Lexington, MA 02421 with credit card info to 781-676-7353 [email protected]

For more information and registration questions, visit our website: www.afceaboston.com or Contact Claire Goulet 781-676-7344; [email protected]