PAMIC : Information Systems Roundtable

IS Roundtable Registration
Monday, April 27, 2009
Penn National Insurance • Two N Second St • Harrisburg, PA

* required field

name*
nickname (for badge)
title
company
address*
city / state / zip code*	P Co de*
phone*
e-mail*
Describe any dietary or accessibility needs, if applicable.

List any topics that you would like to have discussed during the roundtable portion of this event (please indicate if it is for the open forum or outsourcing roundtable):

Event Fee: $40 / person

Select your payment option from one of the following:

I will send a check to pay for my registration.

Please send an invoice.

I will pay online using my credit card.* (Click on the Paypal button after hitting 'Submit.')

* Please note that a $5 service fee will be charged for using this service.