WWW.IIENET.ORG/ETCONFERENCE


April 3 – 4, 2012 The Westin Buckhead Atlanta | Atlanta, Ga.


THROUGH MARCH 13


CENTER FOR ENTERPRISE TRANSFORMATION CONFERENCE


HEART TO HEART CHALLENGE GOLF CLINIC AND TOURNAMENT*


BOTH $995 $995 *For golf tournament registration ONLY, contact Michael Oliff at oliff.michael@yahoo.com. $1,600 REGISTER ONLINE AND SAVE TIME AT WWW.IIENET.ORG/ETCONFERENCE


Please complete: Mr.


Mrs.


Membership #: Last/Surname First:


Preferred first name on badge: Title:


Company: Address: City:


Country:


Please check one: Phone:


Company address Fax:


E-mail: Yes, I require special assistance services. E-mail your request to cs@iienet.org.


Method of Payment: (Conference fees are due in full at registration in U.S. currency only.) Check – made payable to IIE


A check for $


Credit card – Please charge $ Visa


MasterCard Credit card #


Signature: Name of cardholder (print):


Cancellations and Substitutions: Cancellations must be made in writing and faxed to (770) 441-3295 or mailed to IIE, 3577 Parkway Lane, Suite 200, Norcross, GA 30092. See website for deadline for refund. Contact customer service at cs@iienet.org or (770) 449-0460x102 or (800) 494-0460.


is enclosed. Check # to my: American Express Exp. Date: Home address Ms. Dr.


April 2, 2012 Country Club of the South | Atlanta, GA ON-SITE AFTER MARCH 13 $1,195


State/Prov Zip:


REGISTRATION FORM


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