BEST PRACTICES IN MANAGING INDUSTRIAL ENGINEERING REGISTRATION FORM
Monday, November 7, 2011 | Crowne Plaza Chicago O’Hare | Chicago, IL THROUGH NOVEMBER 3
IIE MEMBER NON-MEMBER STUDENT MEMBER STUDENT NON-MEMBER
A team discount does not apply.
REGISTER ONLINE AND SAVE TIME www.iienet.org/ManagingIE
Please complete: Mr.
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 email@example.com
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) 263-8532 or mailed to IIE, 3577 Parkway Lane, Suite 200, Norcross, GA 30092. See website for deadline for refund. Contact customer service at firstname.lastname@example.org
or (770) 449-0460x102 or (800) 494-0460.
is enclosed. Check # to my: American Express Exp. Date: Dr.
$249 $399 $49 $99
ON-SITE AFTER NOVEMBER 3
$399 $549 $49 $99
State/Prov Zip: Home address
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