June 13, 2007 Community of Practice Meeting Registration Form
ljohnston
PMMI Technical Training Community of Practice
Wednesday, June 13, 2007
Please fax to Laura Johnston – 703-907-4207
Or email: ljoh...@pmmi.org
(SPACE IS LIMITED, PLEASE REGISTER EARLY!)
____ YES, I am a member of the Community of Practice and will attend
the June 13th meeting
____ YES, I am not currently a member of the Community of Practice,
but would like to attend the June 13th meeting
____ I will NOT be able to attend the June 13th meeting, but I am
interested in participating in the group. Send me information about
future meetings.
Colleagues who may be interested in participating in the group:
Name Company Title Phone/email
__________________________________________________________________
NAME:
______________________________________________________________________
NICKNAME FOR BADGE:
_______________________________________________________
TITLE:
_______________________________________________________________________
COMPANY:
___________________________________________________________________
ADDRESS:
___________________________________________________________________
CITY: ______________________STATE/PR:
__________ZIP:____________COUNTRY: _____
PHONE: _______________________________ FAX:
_________________________________
E-MAIL:
______________________________________________________________________
Special Needs: Please contact me concerning special needs.
Registration Fee: $50.00
____ I will pay by check.
(Payable to PMMI. Mail to 4350 N. Fairfax Dr., Suite 600, Arlington,
VA 22203)
____ I will pay by credit card.
(For secure, online payment, visit: https://www.pmmi.org/community/registration.asp)
VISA MasterCard American
Express Discover
Card Number: ___________________________________Exp.Date:
_____________________
Cardholder Name:
_____________________________________________________________
We have limited space. Please register by June 1, 2007
Fax completed form to: 703-907-4207 or email to: ljoh...@pmmi.org