DECUS '99/Providence Online Registration Form

7. DECUServe

One - Year Subscription (nontransferable)

$ Free

Storage Days / Compaq Technology Center / DECUS DataCenter / Keynote Speakers / Special Events

DECUS '99/Providence Registration Form

We have provided you with this form as an option for those who do not have the PDF reader installed into your browser or system.

To register for DECUS '99/Providence please fill out the form below and complete all of the required fields. Please contact us directly by mailing or faxing a printout of all of the completed pages in this form to the following:

Mail: DECUS, 2 Results Way, MR02-1/C16,
Marlboro, MA 01752
Fax: 1-508-467-9153
Customer Service: 1-800-DECUS55 (1-800-332-8755)
Outside U.S. & Canada: 1-508-467-9150
Process Code #1006

Personnel Information:

Name:
Company:
Address/Mail Stop:
Address:
City:
State:
Zip:
Country:
E-Mail:
Phone:
Fax:

Method of Payment:

Check (U.S. Funds Only) Payable to DECUS. Form & check must be mailed.

PO# (U.S. Purchase Order Only)
Hard Copy Required

Charge Card Info:	VISA MasterCard American Express
Card Number:
Expiration Date (mo/yr):
Name on Card:

Note: $100 cancellation fee prior to May 28. No refunds will be issued after this date.

1. Check if First Time Attendee: Yes No

2. SEMINARS (Select no more than one per day and indicate by seminar's number.)

Choice 1

Choice 2

Early Bird
(by 5/21)

Regular (after 5/21)

$ Dollar Amount

Half-Day Seminar

#SE211

$250

$350

Saturday Seminars

#SE1

$495

$595

Sunday Seminars

#SE2

$495

$595

3. SYMPOSIUM

Early Bird
(by 5/21)

Regular
(after 5/21)

Four-Day Symposium
(Mon - Thurs, includes Session Notes CD-ROM)

$1395

$1495

Daily Symposium
(Mon - Thurs) Per - Day Rate

$395

$495

Indicate Day:

Mon Tue Wed Thu

(Student discount available - call for details)

4. TRADE SHOW

Free $30 Value Check here for Trade Show Only

$ Free

5. PRODUCTS (Select all that apply and total) Library CD-ROM
LIB1: DECUS Essential Tools Collection, 1997				$ 89
LIB2: DECUS Symposium Collection 23				$ 89
Session Notes CD-ROM				$ 89
(All CDs to be shipped approx. 8 weeks after the event.)

6. MEMBERSHIP (U.S. Residents only)

As a DECUS Event attendee you automatically become a DECUS Basic Member. Should you want to become a DECUS Sustaining Member, the annual fee is $40.00; you will receive a DECUS Polo Shirt and Pin. U.S. Residents Only.

Indicate Size:

S M LXLXXL

8. GRAND TOTAL

ATTENDEE PROFILE - Required

Job Functions:

1. Title/Job Function: (check one)
Computer Systems / Operations / Networking
(101) IS/MIS Director or Manager
(102) Operations/Data Center Manager
(104) Network Administrator / Manager
(105) Data / Telecommunications
(106) Software Developer / Programmer / Analyst
(108) Technical Manager
(109) Other Computer Related
(please specify)
(110) Database Administrator
(111) Operator
(112) Quality Assurance
(113) Project Leader/Program Manager
(114) System Administrator
Administration / Departmental /
General Management
(150) Executive (Pres/Owner/VP/CIO)
(151) Financial/Accounting/Purchasing
(152) Electrical Engineering/Mechanical Engineering
(153) Sales/Marketing/Account Rep
(154) Manufacturing/Production
(155) Scientist/Research/R&D
(156) Other Departmental
Professional and Others
(157) Consultant
(158) Training/Education
(159) Professionals (Legal,Medical,etc)
(160) Other (please specify)

2. Organization, Primarily: (check one)
(201) Consultant
(202) Dealer, Distributor, Retailer
(203) Hardware Manufacturer
(204) Software Developer
(205) Value-Added Reseller
(206) Other Computer Services
(please specify)
(207) Aerospace
(208) Architecture

(209) Automotive
(210) Banking/Finance
(211) Chemical
(212) Consumer Package Goods
(213) Defense
(214) Education
(215) Electronics
(216) Entertainment
(217) Environment
(218) Forestry, Mining, Metals, and Glass
(219) Government, Local
(220) Government, Federal
(221) Government, State
(222) Healthcare
(223) Hobby/Personal Use
(224) Insurance
(225) Media
(226) Oil and Gas
(227) Pharmaceuticals
(228) Professional Services
(229) Retail/Wholesale
(230) Telecommunications
(231) Travel and Transportation
(232) Utilities
(233) Other (please specify)

(234) Manufacturing
(235) Non-Profit
(236) Publishing

3. Annual Computer-Related Expenditures (company-wide):
(check one)
(501) Over $50,000,000
(502) Over $10,000,000
(503) Over $ 1,000,001
(504) $500,001 $1,000,000
(505) $250,001 $ 500,000
(506) $ 50,000 $ 250,000
(507) Don't Know

4. I recommend, approve or purchase computer hardware / software and / or services.
Yes No

Please check back with us frequently for further details.

E-mail questions and comments to: information@DECUS.org
Footer