Special Event Registration

Registration Form
Logical Data Modeling
Tom Haughey
Atlanta

Name       ___________________________________

Job Title   ___________________________________

Company  ___________________________________

Address    ___________________________________

City, State, Zip  _____________________________

Phone Number (       ) _______ - _____________

Email Address _______________________________

User Group Name ____________________________

Registration Fee
( ) $1495 - DAMA, MPO, IDMA, Erwin User group rate if registered
and paid by 1/25/09
( ) $1595 - if registered and paid by 1/25/2009
( ) $1795 - if registered after 1/25/09

Method of Payment
( ) American Express ( ) Master Card ( ) Visa
Name of Card Holder_________________________________
Credit Card Number__________________________________
Security Code______________________________________
Expiration Date_____________________________________

Credit card please call (973) 379-7212 or fax form to (775) 201-9550
Check enclosed (payable to DebTech International L.L.C.)
Please fax Purchase Orders to (775) 201-9550

PLEASE NOTE: REGISTRATION FOR THIS CLASSCLOSES FEB. 11, 2009.

Please mail check payments to:
DebTech International L.L.C.
P.O. Box 162
Short Hills, NJ, 07078