Registration for the GCI Qualifying Seminar and/or IES Workshop

Workshop Dates:
  GCI Qualifying Seminar

July 21-22, 2012
November 17-18, 2012
February 9-10, 2013

IES Workshop

November 16, 2012
February 8, 2013

IES Workshop and GCI Seminar

November 16-18, 2012
February 8-10, 2013

Please make a selection.

Name:
 
Gender:
  Male     Female
First name / nickname
for nametag:
 
Title:
 
Organization:
 
Street
 
City:
 
State/Province:
 
Zip/Postal Code:
 
Country:
 
     
This address is   Home      Work       Both
     
Home phone:
 
Cell phone:
 
Work phone:
 
Fax number:
 
:
 
     
In case of emergency, we should contact:
     
Name:
 
Relationship:
 
Address:
 
Home/Cell phone:
 
Work phone:
 
     
Tuition:
  GCI Qualifying Seminar

US$1500 (personal and business professionals)
US$1200 (academic, government, and nonprofit)

IES Workshop

US$500 (personal and business professionals)
US$400 (academic, government, and nonprofit)

IES Workshop and GCI Qualifying Seminar

US$2000 (personal and business professionals)
US$1600 (academic, government, and nonprofit)

Please make a selection.