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  Speakers

Gala
  Table Top Displays

23rd Annual Fleck Connection Congress


  December 8 & 9, 2011
Location: Sheraton Carlsbad, Carlsbad California 92008

If your browser does not handle forms or for CREDIT CARD payment, please register by phone
(714-953-9000) or print the form and fax to (714-953-5053).
You can also download a PDF version of the registration form.

CONTACT INFORMATION
Name
Title
Company
Address 1
Address 2
City
State/Prov Zip
Telephone
Fax
e-mail

REGISTRATION
General Sessions
In Advance
Late or On-Site
Standard Registration $995 $1,195
Annual Clients Registration $895 $1,095
INTERCONNECT INDUSTRY WORKSHOPS
Fleck Research Additional Data 1:
Technology trends impacting the interconnect industry
$295 $365
Fleck Research Additional Data 2:
Market trends impacting the interconnect industry
 $295 $365
EXHIBIT PURCHASE
Table Top Display Space (6'x3')
 $425 $485
DISCOUNTS


All Registration within the 30 day of the conference date will be considered "On-Site Registrations" at $1,195 for "Standard Registration" and $1,095 for "Annual Clients Registration".

For Countries Outside the USA: Please pay by
[i] Credit card (VISA, MasterCard or American Express); or
[ii] Wire Transfer (call for information); or
[iii] Check or money order to FLECK RESEARCH (drawn on a U.S. bank only)

Registration are transferable and non-refundable. Registrants may have credit towards another Fleck conference or value of a research report. Credit must be used within two years from original registration date.

Programs, speakers, topics and workshops are subject to change without notice.

Transportation and hotel reservations must be made separately.

Upon receipt of your registration form, we will forward information pertaining to the resort, special airline discounts, workshops and/or golf tournament (if applicable), and other related material.

Workshop handouts may not include all of the information that may be displayed or discussed during the session.

PAYMENT INFORMATION

Please Bill Me Check/Money Order Purchase Order #


American Express

Visa

Master Card
Credit Card Payment
Please Print this Page and fax it to (714)953-5053


Card Number:

Exp. Date:

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* Security code is the four-digit code on the front of the card (American Express) or the last three numbers of the number on the back of the card (MasterCard or Visa)

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