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Please print that form and mail that to VIT

Workshop Conformation Form

Name: ____________________________________ Designation : ______________________

Manager's Name: ___________________________ Tel: ______________________________

Name of Organization (Working for): ______________________________________________

Address (Office): _______________________________________________________________

__________________ Fax: _____________________ Tel: ______________________________

Address (Residence): ___________________________________________________________

________________ Tel: _______________________ Email: _____________________________

FEE PAYMENT SCHEDULE

Milwaukee

Chicago

Madison

Date

October 7th 2001

October 14th 2001

November 16th 2001

Timing

9:00 am to 5:00 pm

9:00 am to 5:00 pm

9:00 am to 5:00 pm

Venue

Douglas Plaza

12970 W. Bluemond Rd

Holiday Inn

Rolling Meadows IL

Sheraton Hotel

Madison, WI

(Promotional offer) Cost

$ 150.00

$ 200.00

$ 150.00

Payment by check q Total Due: $_______ Due Date: __________

Payment by Cash q

I hereby confirm that the information given above by me is correct. I agree to the schedule and confirm to attend this highly informative workshop on Windows 98, Ms Office includes: "Basic Concepts, Ms Word, Ms Power Point, Ms Excel and Internet E-mail"

Please Note: Make check payable to David F. Roberts.

Nominee's Signature ______________________

Address : 7205 W. Brentwood Ave

                    Milwaukee, WI. 53223

                    Phone: 414-353-8520

                    email:  vitech@consultant.com

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