Registration Form - Technology Convergence Summit 2008

Technology Convergence: The Integrated Lifestyle

October 9, 2008 iSilverdale Beach Hotel

4:00 pm - 5:30 pm

Technology showcase and cocktail reception

5:30 pm - 7:30 pm

Presentations and dinner

Attendee Registration Fees

	WSTA members*	Non-Members:
Early bird rate	$20	$30
After Sept. 5	$30	$40

*Refers to paid annual membership. Members must be current as of 10/09/08. If you are uncertain of your status, please check the online directory or contact us.

Registration includes:

Technology Showcase
Cocktail Reception
Speaker presentations
Plated Dinner
No-host bar for entire evening

Step 1 of 2 - Mandatory fields in bold face

Name

Title

Company/Organization

E-mail address

Phone number

(include area code)

Fax number

(include area code)

Street address

City/State/ZIP

Which are you attending? (check all that apply):

Technology Showcase/Cocktail Receptions
Presentations and Dinner

Dinner Selection (choose one)

Chicken Piccata with Lemon Caper Sauce and Wild Rice Blend
Stuffed Portabella Mushroom baked with Spinach, Duxelle, Wild Rice, Artichoke & Tomato and Topped with Fresh Asiago Cheese

How Did You Hear About Us?

Additional Comments

Privacy notice: We use the information we collect about you to process your registration fee via credit card, generate your event confirmation information and create name badges for the summit. You will be added to our marketing listserv for future notices of upcoming WSTA events, where we generally do not send more than 2-3 notices per month. We will be providing a registrants list to premier and event sponsors of the Summit. If you do not wish your information to be included in this material, please send us an email to info@wstpa.org with your contact information and we will remove you from the published list.