TeamCAD '97 Registration Form


Please complete this form and fax it to (404) 894-0673 or send it via
postal mail along with your payment to:

              GVU Center
              TeamCAD Registration
              801 Atlantic Drive
              Atlanta, GA 30332-0280

Personal Information:

   First Name:           _________________________

   Last Name:            _________________________

   Full name:            _________________________________________
                          (as you wish it to appear on your badge)

   Company/Institution:  __________________________________________

   Street Address:       __________________________________________

   City, State/Province: __________________________________________

   Country:              __________________________________________

   Postal Code:          ______________________

   Telephone Number:     ______________________

   Fax:                  ______________________

   Email Address:        __________________________________________

   ____  Check here if you will be attending the dinner reception on
         Monday, May 12. 


Workshop Fees:

   $120  On or before April 7, 1997
   $150  After April 7, 1997


Payment Information 

 If paying with a credit card, please specify:

      Visa: ____       Mastercard: ____       American Express: ____

 Card Number:     _________________________________________________________

 Expiration date: ___/___    Card Holder's Name: __________________________

 If paying by check, please make check payable to "Georgia Institute of
 Technology" and send them to the address located at the top of this form.

 You will recieve a confirmation letter that your payment was received. 

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Last Modification: 3/25/97