DAMA DAY 2009 Registration Form

DAMA NJ 2009 DAMA Day Registration Form

* Early registration and payment includes a complimentary copy of
DAMA-International's Body of Knowledge (DAMA-BOK).

Registration is by POSTAL MAIL or FAX Only.   Email and phone registrations are not available.

Please print off the this registration form, complete required information for attendee and
Mail check payments to:   DAMA NJ   P.O. Box 6035   Monroe Township, NJ   08331
Or Fax credit card information to:    fax # 813-990-1084

Name: ________________________________________________________________

Title: ________________________________________________________________

Company: ________________________________________________________________

Address: ________________________________________________________________

City/State/Zip: ________________________________________________________________

Business Phone: ________________________________________________________________

E-Mail: ________________________________________________________________

Are you currently a member of DAMA-NJ:    YES [   ]     No [   ]

You may use this form to register multiple members from the same Corporate or Enterprise Membership ...
(if paying with the same check or with one credit card).
Please include for each member the Name, Title, Bus. Phone Number, and Email Address for each:

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Payment Amount:

[___] $ 195.00 DAMA NJ member rate, if paid on or before September 9th.*
[___] $ 245.00 DAMA NJ member rate, if paid September 10th or after.

[___] $245.00 Non-member rate, if paid on or before September 9th.*
[___] $295.00 Non-member rate, if paid September 10th or after.
Note to non-members, your 2009 DAMA Day registration fee includes a 1-year individual membership to DAMA NJ.

Payment includes lunch and AM/PM breaks.
* Early registration and payment includes a complimentary copy of
DAMA-International's Body of Knowledge (DAMA-BOK).
No refunds - substitutions are allowed.

Payment Method: CHECK [   ], AMEX [   ], DINERS CLUB [   ], Master Card [   ], Visa [   ].

Name of credit card holder:
           ___________________________________________________________

Is credit card billing address the same as listed above?    YES [   ]     No [   ]
If NO - please include the credit card billing address, city, state, zip:
           ____________________________________________________________________________

Card Number:
           __________________________________________________________

Expiration Date:
           _____________________

Signature of Cardholder:
           __________________________________________________________

CHARGES WILL NOT BE ACCEPTED WITHOUT SIGNATURES!!!!

[DAMA NJ Tax ID #22-3244193]

DAMA NJ Home | DAMA Day Announcement

Name:	________________________________________________________________
Title:	________________________________________________________________
Company:	________________________________________________________________
Address:	________________________________________________________________
City/State/Zip:	________________________________________________________________
Business Phone:	________________________________________________________________
E-Mail:	________________________________________________________________