GOMACTech-16 REGISTRATION FORM
March 14-17, 2016
Wyndham Resort International Drive, Orlando, FL
www.gomactech.net

ADVANCE REGISTRATION MUST BE RECEIVED NO LATER THAN 26 FEBRUARY 2016
CANCELLATION/REFUND DEADLINE: 26 FEBRUARY 2016
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 
$575 GOMACTech-16 Conference Registration (includes CD-ROM Digest) ($625 after 26 February 2016)
$325 One Day Registration (includes CD-ROM Digest)
Tuesday Wednesday Thursday
$275 Student (Full Time) Registration (includes CD-ROM Digest)
$125 Trusted Supplier Session - Tutorial I (Monday, 14 March, 8:30am-5pm, lunch included)
$75 Superconducting Technologies - Tutorial II (Monday, 14 March, 8:30am-12:30pm)
$75 Introduction to Linear Photonics - Tutorial III (Monday, 14 March, 1:30pm-4pm)
Wednesday Evening - Sea World Orlando Event

        Adult(s)@$50      Child(ren)@$15
$40 Additional GOMACTech-16 CD-ROM Digest
PART III. PAYMENT INFORMATION
CREDIT CARD:  

VISA MasterCard AMEX Diner's Club

Card Number: Expiration Date:
 
Questions or cancellations: Contact Alicia Waldron 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.)