| Last Name | First Name |
| Job Title |
| Company |
| Mail Address | Mail Stop |
| City | State/Providence | Postal Code | Country |
| [ ] Registration Fee [ ] Early Registration fee, 3 weeks in advance [ ] Group Discount - 10% ($250), 3 or more at the same time * * Send Registration info for each |
$2500.00 ___________ $2100.00 ___________ ___________ Total ____________ |
No credit charges will be made until Seminar is definite
BOOK ORDER -
| # Copies | U.S. Dollars | Sub-Total | |
| __________ |
Semiconductor Technology Handbook |
$400.00 |
___________ |
| [ ] Surface Shipment - U.S. [ ] Air Shipment - U.S. & Canada [ ] Air Shipment - Outside U.S. * Or provide FedEx Acct. No. ___________________________ |
$ 12.00 $ 40.00 $ 85.00 Total |
___________ ___________ ___________ ___________ |
PAYMENT TERMS
Prepayment is required on Handbooks. Payment must be made by credit card, check, or bank transfer to the account of Component Technology Institute. Please contact CTI for transfer information. All checks and transfers must be free of bank charges.
Payment by [ ] Check [ ] Bank Transfer [ ] American Express [ ] MasterCard [ ] Visa
Account No.: ________________________________________________ Expiration:__________
Cardholder’s Signature: ___________________________________________________________
Print Cardholder’s Name: _________________________________________________________