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IEEE 802

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IEEE 802 Powered By Docstoc
					                                      IEEE 802.16
                          Session # 45, September 25-28, 2006
                               Mont Tremblant, Canada
                            Registration Fee Payment Form


Please use this form to process your registration fee for IEEE 802.16 Session #45 ONLY if
you are NOT booking a room through Mont Tremblant.

Please fill out the form and fax or email back to:

Isabelle Pilon, Wavesat
Fax:            +1.514.684.0211
Telephone:      +1.514.684.0200
Mobile:         +1.514.814.8928
Email:          ipilon@wavesat.com


Name:

Company:

Company Address:

Email address:

Telephone:

Fax:


Registration Fee for Session 45 is US$300 through August 25 and US$400
thereafter.
Payment information

Credit card Type: Visa              Master Card      American Express

Card Number:

Expiration Date:

Billing Address (if different from above):




Name on card:

Signature:


                                                                Thank you.

				
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