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 email@example.com
. $1,600 REGISTER ONLINE AND SAVE TIME AT WWW.IIENET.ORG/ETCONFERENCE
Please complete: Mr.
Membership #: Last/Surname First:
Preferred first name on badge: Title:
Company: Address: City:
Please check one: Phone:
Company address Fax:
E-mail: Yes, I require special assistance services. E-mail your request to firstname.lastname@example.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 email@example.com
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
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