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ProSim '98 Registration Form

Oregon Center for Advanced Technology Education (OCATE)
18640 NW Walker Rd., Suite 1010, Beaverton, OR 97006
TEL: (503)725-2200 - FAX: (503)725-2201
EMAIL: info@ocate.edu - WEB: www.ocate.edu

Please complete ALL parts of registration for room assignment & registration process.

Name: ___________________________________________________________________

Company Name: ___________________________________________________________

Mailing Address: ________________________________________________________

City / State / Zip: _____________________________________________________

Work Phone: _____________________________________________________________

Email: __________________________________________________________________

Semi-private, two-person room
____ $590 early (postmarked before May 8)
____ $690 late (postmarked after May 8)

Single person room (limited number available)
____ $765 early (postmarked before May 8)
____ $865 late (postmarked after May 8)

____ Enclosed is a check made payable to OCATE
____ Please charge my registration fee to my credit card:

____ Visa ____ MC  Visa/MC account # ____________________________________

Exp. Date ________________ Signature: ___________________________________

Personal Information:
____ Male        Special Dietary Needs (specify):	
____ Female      ________________________________________________________

Name of roommate requested: _____________________________________________

How did you hear about conference?_______________________________________

Where will you be boarding the shuttle?
___ from Hilton @ 3:00 PM 
___ from Airport @ 3:30 PM 
___ No shuttle needed; obtaining own transportation

___ I need Portland area hotel information