Spring 2010 Registration Form

Spring 2010 Meeting in Philadelphia, PA, March 23, 2010

REQUESTS FOR REFUNDS OF REGISTRATION FEES (less credit card processing costs) MUST BE RECEIVED NO LATER THAN FIVE DAYS BEFORE MARCH 23, 2010. AFTER THAT DATE, OR IF YOU DO NOT ATTEND THE MEETING, A CHARGE OF $175 WILL BE MADE TO COVER THE FIXED COSTS ASIDIC INCURS FOR LATE CANCELLATIONS.
For refund requests, telephone or fax (215)-654-9129, or send e-mail to info@asidic.org.

Please Note: On-site (walk in) registration fees will be $250 for Members and $295 for Non-Members.

* Indicates required field

*Name:
*Affiliation:
Title:
*Address:
*City:
*State:
*ZIP Code:
Phone:
*E-mail:

First ASIDIC Meeting?

Please check if this is your first ASIDIC meeting Please select an option

Dietary Requirements:

*Conference Registration

ASIDIC Member, $225 Non-Member, $250 Please select an option

*Payment Options

Credit Card--Visa Credit Card--Mastercard Credit Card--American Express Check mailed to the address below Payment at meeting Please select an option

Credit Card Number:
Expiration Date (mm/yy):
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