Please use this secure online registration form to register for the 2008 AssurX Summit User Conference. You will receive a confirmation email within 48-72 hours. Please note that the conference fee is non-refundable after August 25, 2008. However, if you wish to transfer your registration to someone else in your organization, please call: 408-778-1376, ext. 707.
If you prefer, you may fill out the form below and print and FAX it to us at 408-776-1267. You will receive a confirmation via email.
First Name:
Last Name:
Title:
Company:
Credit Card Billing Address:
City:
State/Province:
Zip/Postal Code:
Country:
Credit Card Billing Phone Number:
Business Phone Number:
E-mail address (required):
Please choose method of payment: (Visa/MasterCard/AmericanExpress)
Name as it appears exactly on card:
Credit Card Number:
Expiration Date:
Registration Fees:
$995 (Before August 25, 2008)
$1,095 (After August 25, 2008)
Spouse Event Fee:
(This fee covers all cocktail/dinner fees for both the kickoff dinner at High Camp, as well as the dinner on Tuesday night)
$175 (Before August 25, 2008)
$225 (After August 25, 2008)
Spouse Name (for badge):
May we include your name and contact info on our attendee roster to be shared with other attendees?
