Registration

Please fill out the following form and use the submit button at the bottom to send your registration.

Please identify how you learned about our programs:

Brochure received in mail
Program calendar received in mail
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Personal Information:

Name:
Badge Nickname:
Date of Birth:
Position:
Organization:
Mail Stop:
PO Box or St:
City:
State:
Zip:
Phone (W):
Fax:
E-mail:
Dietary Needs:

Payments Information

Program Fee: $1295 | SME Members: $1165

I am a member of SME (Society of Manufacturing Engineers)
SME Membership Number

Payment request is being processed
Check will be sent through mail
Bill my organization on:

  Purchase order #:
  To the attention of:
Name:
  Department:

Credit Cards: We are unable to accept credit card payments on-line. You may print and fax this form to 480-965-8653 with a charge card number and expiration date or telephone us.
Card #: _______________________________________________________
Exp. Date ___________
Card Security Code: ____________ (What/where is Card Security Code?)

Program Selection

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