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Printable Version

Bridging Program

HANDS-ON WORKSHOP
Hands-On Wireless Sensor
Network Systems Workshop
June 15 - 17, 2005, Vancouver, BC

Registration Form

PERSONAL DATA

#1 Title

#2 First Name

#3 Last Name

#4 Affiliation

#5 Position

#6 Street Address

#7 City

#8 Province

#9 Postal Code

#10 Telephone (Home)

#11 Telephone (Work)

#12 Fax Number

#13 Email Address

COURSE FEE

Registration Fees
(Note: Early Bird Discount ends

PAYMENT INFORMATION

#14 Method of Payment

Please choose a method of payment:

Cheque (made payable to: Vitesse Re-Skilling Canada Inc.)

Visa

MasterCard

Amex

Cheques can be mailed to the following:
Vitesse Re-Skilling^TMCanada Inc.
349 Terry Fox Drive, Flr. 3
Kanata, ON K2K 2V6
Attn: Annalisa Garbe

Note: You will only be registered upon receipt of cheque.

If you are paying by credit card, you will be contacted by phone for credit card information.
Thank you!