IEEE 802.16 Session #15 Registration Form

Use this form to register for Session #15.

(1) Provide information about yourself, using (a), (b), or (c):

(a) I am an 802.16 Member:

(b) I am an 802.16 Observer:

(c) I am not listed above, or I wish to update my contact information:

First Name: Middle Initial: Last Name:
Company/Organization:
Department: Title:
Address Line 1:
Address Line 2:
City:
(USA/Canada only)    Other District:
Country: Postal Code:
Telephone: Fax: E-Mail:

(2) Select the action you wish to take:

Preregister for Session #15. Your registration fee of US$120 will be payable on-site by credit card using a registration fee form (which you can download and complete electronically). Please cancel your registration immediately if your plans change!
Cancel registration for Session #15, or simply report that you won't be able to attend this time.

(3) Please answer the following:


Do you plan to stay at the Denver Marriott Southeast? No Yes. {If so, you should reserve a room immediately}.

(4) Comments:

Confidentiality:

Your name and company may be posted on the publicly-available web site. It is 802.16 policy to keep your contact information confidential; it may be posted to the password-protected 802.16 site.

Upon submission, you should receive the message "Your form input has been noted. Thank you!" If you have trouble, please email the relevant information to Roger Marks.

To confirm your registration, see the preregistration list.

Updated: 12 June 2001 by Roger Marks

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