Please use the following form to register as a student attendee for IIT's VoIP Conference and Expo on October 25 and 26, 2007. Registration includes access to both days of the conference and expo (choice of presentations), breakfast and lunch on both days, conference tote bag with materials, and a wine and cheese reception after the first day of the conference.

Personal information

First Name
Last Name
Address Line 1
Address Line 2
City
State / Province
Zip
Phone
Email

School Information

This information is used for identification badge purposes.

School Name
Address Line 1
Address Line 2
City
State / Province
Zip

Continuing Education Credit Information

Would you like to recieve Continuing Education Credits (CEUS) for attending the conference?

I want CEUs
I do not want CEUs

Birthdate Information Required for CEUs

This information is only needed if you would like Continuing Education Units for attending the conference (for accredidation compliance purposes).

Date of Birth
(mm-dd-yyyy)

Payment Information

Choose your payment method                                      

Pay by credit card online
Pay by mailed check
Pay by purchase order

How did you hear about IIT's VoIP Conference?

Please check all that apply.                                                                                                                                                                                                                                    

Email
Society Membership
Flyer
Friend or co-worker
Website or Search Engine

Networking Information

Check if you do NOT want to share your information with conference exhibitors and presenters.

I do not wish to share my information.

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