CESC 2005 Registration Form

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					                                                              CESC 2007
                                                           Registration Form
                                                           April 10-12, 2007
                                                          Omni Shoreham Hotel



Personal Information (* denotes required information)

*First Name                           *Last Name

*Affiliation

*E-mail

*Phone                                     Fax

Note: If the registration fee is paid by credit card, the address below must match the
billing address for the credit card.

*Street Address 1

Street Address 2

*City                        *State                *Zip



Payment Information

        Check Enclosed ( Payable to KRL Science Management/CESC 2007 )

I wish to pay by the following Credit Card:
       MasterCard
       Visa
       American Express

Credit Card Number

Card Identification Number

Name as it appears on Credit Card

Expiration Date
Information:

Registration Fee
Advance registration fee: $375.00 (US dollars)

Advance registration deadline: March 28, 2007 .

All advance registration payments are to be made by credit card, check or money order, and
registration is not complete until payment is received.

If space is still available, registration fee after March 28, 2007: $425.00 (US dollars)

If not registering online, fax or mail your registration form and payment, if applicable, using the
following information:

Fax: (515)-956-3699

Mail: CESC 2007 Conference Registration
      1609 Golden Aspen Drive, Suite 101
      Ames, Iowa 50010

Cancellation Policy
All changes and cancellations must be submitted in writing either via e-mail to
cesc@krellinst.org or by regular mail to the address listed above. Cancellation requests must be
received on or before March 28, 2007 in order to qualify for a refund less a $25.00 processing
fee. A $75.00 processing fee will be charged for cancellations received between March 29,
2007 and April 9, 2007. Refunds will be processed based on the original form of payment
within 30 days after the close of the meeting. No-shows will be charged the full registration
fee.

Credit Cards
CESC 2007 accepts Visa, MasterCard, and American Express.

       To Find Card Identification # (this number is recorded as an extra security precaution):

       American Express: Card Identification number is the 4-digit, non-embossed number
       printed above your account number on the face of the card.

       Visa: Card Identification number is the 3-digit, non-embossed number printed on the
       signature panel on the back immediately following the Visa card account number.

       MasterCard: Card Identification number is the 3-digit, non-embossed number printed on
       the signature panel on the back of the card.

				
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