ISACA Puerto Rico

Registration Form

SECOND ANNUAL SYMPOSIUM
Wednesday, December 3, 2003,
Embassy Suites Hotel-Conference Rooms,
Isla Verde Puerto Rico

Registration Form
Name:		*
Company Name:		*
Member #:
Address:
Address2:
City:
State:
Zip Code:
Telephone:		*
e-Mail:		*
I hereby authorize ISACA Puerto Rico to charge my VISA or MC credit card with the information provided below for the amount of:		*
Card Type:
Card #:
Expiration Date:
Your name as appear in credit card:
If Paying by check send check to:		ISACA PUERTO RICO PO Box 191450 San Juan, PR 00919-1450

Special 30% Discount Offer for ISACA members:

Members who register before October 30th will pay $140.00 per participant. This includes study/reference material, 6 CPE certificate, lunch and breaks, visiting sponsors areas, among other surprises. After October 30th, members pay $170.00. The regular price for non-members for the symposium will be: $200.00 per participant.