PRE-REGISTRATION FORM
2002 IEEE INTERNATIONAL FREQUENCY CONTROL
SYMPOSIUM & PDA EXHIBITION

Last Name First Name M.I.
Organization
Street Address/Mail Stop
CityStateCountryZip Code
Telephone No.Fax No.
E-Mail Address
Cost if Received
Pre-Registration Fees By May 10After May 10
IEEE/PDA Member with Proceedings on CD$375$425
IEEE/PDA Member with Paper Proceedings$475$525
IEEE/PDA Member No. (_____________________________)
UFFC-S Member? _____ Yes _____ No
Non-Member with Proceedings on CD$450$500
Non-Member with Paper Proceedings$550$600
Student/Retiree with CD Proceedings$100$100
Student/Retiree without Proceedings$ 50$ 50
IEEE Life Member without Proceedings$ 50$ 50
One Day without Proceedings$225$225
One Day with Proceedings on CD$275$275
One Day w/o Proceedings with Lunch$275$275
 
UFFC Digital Archive CD package$ 30$ 30
Extra Copy of the Proceedings$100$100
 
Tutorial Pre-Registration Fees
IEEE/PDA Member$175$200
Non-Member$200$225
Student/Retiree$ 50$ 50
 
Guest Registration$ 40$ 40
Exhibition ONLY$ 0$ 10
Coffee Break Sponsorship$350$350
Total Amount Due:  $$

All checks MUST be in US dollars, drawn against a US bank or it will be returned to you unprocessed.
Checks should be made payable to: "2002 IEEE FCS & PDA Exhibition" and be mailed with this form to: Synergistic Mgt. Inc., 3100 Rt. 138, Bldg. #3, Wall Twp., NJ 07719

Credit card registrations ONLY can be faxed to: 1.732.681.9314 or e-mailed to: mcgivneyb2@aol.com Questions? call: 1.732.280.2022

Credit Card (V/MC/AE #:)
Exp. Date: Signature: