Course registration and payment must be received by April 27, 2004. Course enrollment is limited to 20 students. Please fill in the following form and return it (FAX preferable) with payment (see below) to:
 

Information Technology Centre ITC 25

Faculty of Computer Science, University of New Brunswick

P.O. Box 4400, Fredericton, N.B. E3B 5A3

Phone: (506) 447-3220 FAX: (506) 453-3566 E-mail: itc@unb.ca
 
 

Name: ________________________________

Title: _______________________________

Affiliation:__________________________

Address:______________________________

______________________________________

Telephone number:_____________________

FAX number:___________________________

E-mail address:_______________________

Registration fee: $750.00 (684.78 + 65.22 HST)
 

Registration includes morning coffee, refreshment breaks, lunch on three days, course notes and a reference textbook to keep. Each student has exclusive use of a modern workstation (with zip drive) during the hands-on labs. A computer projection system is used for delivering course material.
 

Method of payment (check one):

Cheque Money Order Credit Card: VISA, MasterCard
 Invoice P.O. # _____________

Card Number:________________________

Name of Card Holder: ____________________
(please print or type)

Expiration date:___________________

Your Signature: _________________________ (required for credit card payment only)

Date signed:______________________
 

Please register my CEUs with EIC   [  ]
Technical Society/Prof. Eng. Association:________________________
Membership No.__________________

Cheque or money order remitted in Canadian dollars is to be made payable to the "UNB Information Technology Centre".