FTC `97 Registration

To register for the 1997 Fall Technical Conference, please print this page and submit separate registration forms for the conference and the hotel. Send the registration forms to

Conference registration M.A. Bailey, P.O. Box 249, Hockessin, DE 19707-0249
Hotel registration Omni Inner Harbor Hotel, Reservation Dept., 101 W. Fayette Street, Baltimore, MD 21201
Phone: (410) 752-1100

Conference Registration Form
Attention: M.A. Bailey, P.O. Box 249, Hockessin, DE 19707-0249
Please circle the sessions that you will most likely attend:

Thursday, October 16:   1A  1B  1C  2A  2B  2C  3A  3B  3C
Friday, October 17:     1A  1B  1C  2A  2B  2C  3A  3B  3C

Name: ______________________________________________________________

Badge Name:  _______________________________________________________

Company:  __________________________________________________________

Address:  __________________________________________________________

City/State/Zip:  ___________________________________________________

Telephone:  ________________________________________________________

Please circle whichever categories apply:

I am a:             Member       Senior         Fellow        of ASQC

I am a:             Member       Senior         Fellow        of ASA

I am in Division:                C&PID          STAT          ASA-SPES

                     I am not a memeber of ASQC or ASA


REGISTRATION FEES:

Please submit one form for each person attending.

Two days..............................................................$190
Thursday, October 16th only...........................................$150
Friday, October 17th only.............................................$150
Student (ID Required).................................................$ 75
Late Registration Fee (after September 15th)..........................$ 10

Pre-conference Short Courses, October 15th
  Using Designed Experiments to Shrink Health Care Costs..............$150
    Course Text (required to attend), ASQC Members....................$ 36
    Course Text (required to attend), non-ASQC Members................$ 40
  How to Apply Statistical Thinking to Improve Results................$150

Tour of Baltimore, October 16th.......................................$ 45
Harbor Dinner Cruise, October 16th....................................$ 40
Tour of Annapolis, October 17th.......................................$ 45

Total.............................................................$_______




                          MAKE CHECKS PAYABLE TO FTC-1997.
                      No credit cards/purchase orders accepted.
                        All fees payable in U.S. dollars only.

        Federal Tax ID #390912502                          Detach Here
DON'T FORGET TO REGISTER SEPARATELY FOR THE HOTEL.
Hotel Registration Form
Mail to: Omni Inner Harbor Hotel, Reservation Dept., 101 W. Fayette Street, Baltimore, MD 21201
Phone: (410) 752-1100
Name:  __________________________________________________________________________

Company:  _______________________________________________________________________

Address:  _______________________________________________________________________

City/State/Zip:  ________________________________________________________________

Telephone:  _____________________________________________________________________

Please reserve  _______________(# of rooms) for  __________________( # of people)

For arrival on  ________________________ Depart on  _____________________________

Name(s) of person(s) sharing accomodations:

_________________________________________________________________________________

_________________________________________________________________________________

Check or money order enclosed in amount of $  ___________________________________

Credit Card #  _____________________________________________ Exp. Date  _________

Circle One:  AMEX  MasterCard  VISA  Other (specify)_____________________________

I authorize the Omni Inner Harbor Hotel to charge my account for one night's
deposit and all applicable taxes.

Signature  ______________________________________________________________________


PLEASE MAKE RESERVATIONS BY SEPTEMBER 15TH!!

DON'T FORGET TO REGISTER SEPARATELY FOR THE CONFERENCE.