SAC 2006 REGISTRATION FORM August 17-18, 2006 Montreal, Quebec, Canada Surname: _________________________ Given Name: ____________________________ Organization: ______________________________________________________________ Address: ___________________________________________________________________ ____________________________________________ Postal/ZIP Code: ______________ Phone: _______________________ e-mail: _____________________________________ [ ] Check here if you do NOT want your contact information included in the workshop list of participants. CONFERENCE REGISTRATION: (Please check the appropriate box.) ** You must be enrolled as a full-time student to receive student rate. ** [ ] Early Registration (by July 10): ................... $350. $________ [ ] Late Registration (after July 10): ..................$400. $________ [ ] Early Student Registration (by July 10): ............ $200. $________ [ ] Late Student Registration (after July 10): .......... $250. $________ [ ] Extra Banquet Tickets @ $50 each:................( )x$50. $________ TOTAL AMOUNT PAYABLE:............................................. $________ Notes: - The total amount must be paid upon registration. - Receipt will be issued for the registration amount only. Method of Payment:[ ]Credit Card [ ]Cheque in Canadian funds (payable to "Concordia University") Payment by Credit card (select one): [ ]Visa [ ]Mastercard Name on Card: __________________________________________ Card Number: ___________________________ Expiry Date: _____/_____(mo/yr) Cardholder's signature: ________________________________ ************************************************************************* Mail or FAX this form to: (514) 848-3171 Attn: Ms. Sheryl TABLAN SAC 2006 Concordia Institute for Information Systems Engineering. Concordia University, 1425 René Lévesque Blvd. West, Suite: CB-410-3 Montréal, Quebec, H3G 1T7, Canada.