Online Registration

April 5-7, 2006 -- Hyatt Regency Hotel -- Houston, TX

REGISTRATION FORM

Conference:
First Name:
Last Name:
Position:
Organization:
Address:
City:
State/Prov:
Zip/Postal Code:
Country:
Tel:
Fax:
E-mail:
Main Supervisor:

Please Select from the following:

Mexican Energy 2006


Early Bird (no later than March 3, 2006)	.....................................................	$1,350.00
Standard	.....................................................	$1,495.00
Goverment	.....................................................	$975.00

Pre-Conference Workshop


Early Bird (no later than March 3, 2006)	.....................................................	$550.00
Standard	.....................................................	$595.00
Goverment	.....................................................	$395.00

Please apply the following discount, if applicable, to the tuition:

	Team Discount

	I would like to receive email announcements of upcoming Infocast conferences

Payment Options:

	Please charge my credit card:
		American Express

		MasterCard

		Visa

	Card Number

	Name on Card

	Exp. Date

	Card Country


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