Registration Form

Rapid Prototyping & Manufacturing:
Applications in Product Development, Design, and Tooling
October 6 - October 8, 1998

The following fields are required in order for your registration to be processed:
Name, Address, City, State, Zip, Phone# and Email.

Name:	*Social Security Number:
Position:	Organization:
Address:	City:

State:

Zip:

Phone #:

Fax #:

E-mail:

$225	A Special Primer: Fundamentals of RPM, October 6, 8:00 am to 5:00 pm (includes course notes and breakfast, lunch, and breaks)
$395	The Symposium & Exhibition: RPM Applications and Rapid Tooling, October 7 & 8. (includes admission to all symposium presentations, exhibition hall, symposium proceedings, breakfast, lunch and breaks each day, plus an evening reception at the exhibition on October 7)
$545	Both A & B: Special Primer and the Symposium & Exhibition
-20%	Group Discount (available to groups of three or more from the same company)

Course materials are available only to course attendees
*SS# is used to confirm name retrieval for CEU transcripts.

Payment Method:

For payment, we accept checks, or VISA, MasterCard, American Express, or Discover cards. Registrants should make payment arrangements prior to the start of the program.

For Checks:
1. Mail check to address below. (Please make check payable to Georgia Tech)

For Credit Cards:
1. Fax credit card information to (404) 894-4133. (This is a confidential fax number)
2. Call (404) 894-8308 with credit card information.

Please include the following credit card information:
    a. Card Number
    b. Expiration Date
    c. Cardholder's Name
    d. If faxed, please include the Signature.

Georgia Institute of Technology
RPMI Suite 80
813 Ferst Drive
Atlanta, GA 30332-0406