Vendor Form for CCSC:SE Conference

 

November 12-13, 2010

Spelman College

Atlanta, GA

 

Please make your check payable to CCSC for the amount of $50.  Mail your check along with this form to Dr. Julia Benson-Slaughter at:

 

          Department of Mathematics/Computer Science/Engineering

          Georgia Perimeter College, Dunwoody Campus

          2101 Womack Road

          Dunwoody, GA 30338

          julia.benson-slaughter@gpc.edu

          (770) 274-5152

 

Company Name ________________________________

 

Contact Person _________________________________

 

Address _______________________________________

 

             _______________________________________

 

             _______________________________________

 

Telephone _____________________________________

 

E-mail ________________________________________

 

Number of people attending:                      

 

Any special requirements?

 

_______________________________________________________________________

 

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If you are interested in attending the conference banquet or luncheon, please include $25 per ticket to the banquet and/or $10 per ticket to the luncheon in your payment.