Please SELECT (circle) one of the following dates & course #:

Friday, January 17, 2003 (course # TC03621) Austin, Texas
Friday, March 28, 2003 (course # TC03622) Austin, Texas

Name:
Organization:
Email address:
Address:
City:
Zip Code:
Day Phone:
Fax:
Evening Phone:

Check for $_____________________($200/person) fee enclosed
(Make check payable to the University of Texas at Austin)

Please charge to (Circle type of card)
MasterCard    Visa    American Express     Discover
Account Number:
Expiration Date:

Cardholder’s name (as it appears on the card)

I have read the refund policy.

Signature:_____________________________________________________

* To register by mail: Send completed registration form and
payment to:
Registrar -Thompson Conference Center
The University of Texas at Austin
P.O. Box 7879
Austin, TX 78713

* To register by FAX: FAX completed registration form,
with your credit card and expiration date, to (512) 471-0647.

* To register by phone: Call the registrar at the Thompson
Conference Center at (512) 471-3121 in Austin, or
(800) 882-8784 outside the Austin area. Provide your
credit card and expiration date.