GOMACTech-14 REGISTRATION FORM
March 31 - April 3, 2014
Embassy Suites Hotel, Charleston, SC
www.gomactech.net

Reliability, Remembering the Recipe

ADVANCE REGISTRATION MUST BE RECEIVED NO LATER THAN 14 MARCH 2014
CANCELLATION/REFUND DEADLINE: 14 MARCH 2014
PART I. NAME AND ADDRESS 

First Name
Last Name
Initial

Rank or Title

Company/Gov't Agency/University

Affiliation Address (Street/Avenue)
Mail Stop/P.O. Box/Code

City
State
Zip Code

Phone Number
Fax Number
E-mail
PART II. REGISTRATION 
$550 GOMACTech-14 Conference Registration (includes CD-ROM Digest) ($600 after 14 March 2014)
$300 One Day Registration (includes CD-ROM Digest)
Tuesday Wednesday Thursday
$250 Student (Full Time) Registration (includes CD-ROM Digest)
$100 Trusted Supplier Session (Monday, 31 March)
$50 Advanced Components for EW (ACE) (Monday, 31 March)
$50 Understanding the Impact of Reliability on Advanced CMOS Electronics (Monday, 31 March)
Wednesday Evening Dinner - The Blues and BBQ Dinner Cruise

        Adult(s)@$30      Child(ren)@$10
$40 Additional GOMACTech-14 CD-ROM Digest
PART III. PAYMENT INFORMATION
CREDIT CARD:  

VISA MasterCard AMEX Diner's Club

Card Number: Expiration Date:
 
Questions or cancellations: Contact Mark Goldfarb at (800) 350-0111; fax: (212) 460-5460; [email protected]
GOMACTech is an Export-Controlled event that requires proof of U.S. Citizenship or legal U.S. Permanent Resident status. Additionally, a signed Non-Disclosure Statement (must be signed onsite) will be required.)