DE Systems Symposium Companion Meal Registration

DIRECTED ENERGY PROFESSIONAL SOCIETY

Directed Energy Systems Symposium
Companion Ticket Order Form

2-5 April 2012 Gaithersburg, Maryland

Thank you for your support of DEPS activities. This form permits you to purchase a companion's reception ticket for the Directed Energy Systems Symposium separately from your symposium registration. Several methods of payment are offered, including using our secure server to pay on-line at this time.

All information requested below is required to process your request.

Personal Information

Registrant's Name:

Address:

City:

State:

Zip code:

Phone:

E-mail:

E-mail (confirm):

To reduce errors, we ask that you enter your email a second time.

Selection:

Companion reception ticket for $40. (Includes only the Tuesday evening reception.)

Companion's Name:

Payment

    Submit credit card payment at this time using our secure server

    Bring payment to the DEPS registration desk.

Note: The DEPS registration desk will be open from 1500-1800 Sunday, 1 April at the conference hotel.

Cancellation Notice

Persons requesting cancellation prior to 27 March will receive a full refund. No refunds will be given after 27 March.

Once you have completed the fields on this form, press the Submit button to process this information. You will be given a chance to review your registration prior to final submission. The Reset button will clear the entire form.



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Last updated: 28 March 2012