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On-line Registration

This is a Demonstration of an Online registration form used by Summit Professional conference management software. Please feel free to test this form.

To test the complete system you will need the Summit Pro software as well as the Online Demonstration event file.

Your company name:    
Your email:
  registration email will be sent to this address. You can then use the Summit Internet Assistant to import the registration data into the demonstration event file.
First Name: (Required)
Family Name: (Required)
Badge Name:

(only if different from above - badge will show first and last name) 
Organization: (Required)
Address Line 1: (Required)
Address Line 2:  
City: (Required)
Province: (Required)
Postal Code: (Required)
Country: (Required)
Phone: (Required)
Fax: (Required)
E-Mail Address: (Required)

Accompanying Person
Title: Prof.  
First Name:  
Last Name:  
Are you a Member
I am interested in becoming a Member (Our office will be in touch with further details)

For more information on this demo registration form please contact:
Pharos Internet Solutions Ltd. :::

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