MCS Symposium Registration



REGISTRATION FORM — 2017 MCS SPRING SYMPOSIUM NAME: FORMTEXT ?????AFFILIATION: FORMTEXT ?????ADDRESS: FORMTEXT ?????PHONE: FORMTEXT ?????FAX: FORMTEXT ?????E-MAIL: FORMTEXT ?????Please indicate if you will register as: FORMCHECKBOX Regular member: $75 FORMCHECKBOX Student member: $50 FORMCHECKBOX Non-member: $100 (including $25 MCS membership due) FORMCHECKBOX Student non-member: $60 (including $10 MCS membership due)I wish to register a vendor table(s) for the Symposium at a cost of $500 per table*: FORMCHECKBOX Yes FORMDROPDOWN No. of TablesPlease indicate if you will attend the dinner. If you do not attend dinner, there is no refund, but your money will be used to support student participation at the meeting. FORMCHECKBOX I will attend the dinner. FORMCHECKBOX I will not attend the dinner.Reservations:Must be made prior to 12:00 PM (noon), Tuesday, April 25, 2017 for guaranteed meals by returning the completed registration form to Andrew “Bean” Getsoian (agetsoi1@). Payment: Registration fees can be paid in cash or by check on the day of the symposium. If you wish to pay in advance, you may do so by mailing a business / personal check or a money order to the following address: Andrew Getsoian, Ford Motor Company, 2101 Village Rd MD 3179, Dearborn, MI 48124. ................
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