**17^th^ International Meshing Roundtable -- October 12-15, 2008 --
Pittsburgh, Pennsylvania, USA\
DEADLINE: August 30, 2008. After this date registration fee is \$650.
Return this form with payment to the address provided.\
\
\
**

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| # Contact Information        |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Name:                        |          | Title:  |                 |
+------------------------------+----------+---------+-----------------+
| Company Name:                |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Mailing Address:             |          |         | Mail Stop:      |
+------------------------------+----------+---------+-----------------+
| City:                        | State:   |         | Zip:            |
+------------------------------+----------+---------+-----------------+
| Country:                     |          |         |                 |
+------------------------------+----------+---------+-----------------+
| E-Mail Address:              |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Telephone:                   | Fax:     |         |                 |
+------------------------------+----------+---------+-----------------+
| ### Participation (Plea      |          |         |                 |
| se check one answer to each  |          |         |                 |
| of the questions below.) Ban |          |         |                 |
| quet guests 12 & under ½ pri |          |         |                 |
| ce, toddlers & infants free. |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Short Course, Sunday October |          |         |                 |
| 12^th^ @ \$150 per person    |          |         |                 |
| (lunch included)\            |          |         |                 |
| I will attend: Yes No        |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Poster Session, Monday,      |          |         |                 |
| Noon, October 13^th^,        |          |         |                 |
| Doubletree Hotel & Suites\   |          |         |                 |
| I will attend: Yes No        |          |         |                 |
+------------------------------+----------+---------+-----------------+
| I will have an entry(s) for  |          |         |                 |
| the Poster Session: Yes No\  |          |         |                 |
| If yes, how many entries?    |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Guest(s) will attend Poster  |          |         |                 |
| Session\                     |          |         |                 |
| Yes No If yes, how many?     |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Banquet & Awards: Tuesday    |          |         |                 |
| Evening, October 14^th^,     |          |         |                 |
| Doubletree Hotel & Suites\   |          |         |                 |
| I will attend: Yes No        |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Guest(s) will attend         |          |         |                 |
| Banquet: \$75 per person:    |          |         |                 |
| Yes No\                      |          |         |                 |
| If yes, how many?            |          |         |                 |
+------------------------------+----------+---------+-----------------+
| T-shirt Size: small medium   |          |         |                 |
| large x-large xx-large\      |          |         |                 |
| Additional T-shirts @\$15.00 |          |         |                 |
| each: How many? Size(s):     |          |         |                 |
+------------------------------+----------+---------+-----------------+
|                              |          |         |                 |
+------------------------------+----------+---------+-----------------+
| # Special Needs              |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Please indicate if you       |          |         |                 |
| require special              |          |         |                 |
| accessibility or             |          |         |                 |
| accommodations. (vegetarian, |          |         |                 |
| vegan, disability            |          |         |                 |
| accommodations, audio/visual |          |         |                 |
| requirements, etc.)          |          |         |                 |
+------------------------------+----------+---------+-----------------+
| # Security Information       |          |         |                 |
+------------------------------+----------+---------+-----------------+
| US Citizen: Yes No If No,    |          |         |                 |
| please fill in the below     |          |         |                 |
| information. Because this is |          |         |                 |
| a Sandia Laboratory          |          |         |                 |
| organized event, DOE         |          |         |                 |
| requires the below           |          |         |                 |
| information from non-United  |          |         |                 |
| States citizens. No other    |          |         |                 |
| action is required.          |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Full Name and middle         |          |         |                 |
| initial: Date of Birth       |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Place of Birth: Current      |          |         |                 |
| Citizenship:                 |          |         |                 |
+------------------------------+----------+---------+-----------------+
| **Registration Fees &        |          |         |                 |
| Payment (No Refunds)**       |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Full Registration @ \$535    |          |         |                 |
| (on/before Aug 30^th^) per   |          |         |                 |
| attendee \$                  |          |         |                 |
|                              |          |         |                 |
| Full Registration @ \$650    |          |         |                 |
| (after Aug 30^th^) per       |          |         |                 |
| attendee \$                  |          |         |                 |
|                              |          |         |                 |
| Student Registration @ \$150 |          |         |                 |
| per attendee \$              |          |         |                 |
|                              |          |         |                 |
| (students will receive the   |          |         |                 |
| proceedings on CD only)      |          |         |                 |
|                              |          |         |                 |
| Short Course @ \$150 per     |          |         |                 |
| attendee \$                  |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Guest(s) attending Banquet @ |          |         |                 |
| \$75 per person \$           |          |         |                 |
|                              |          |         |                 |
| (12 and under ½ price,       |          |         |                 |
| toddlers and infants free)   |          |         |                 |
|                              |          |         |                 |
| Additional T-shirts @ \$15   |          |         |                 |
| each \$                      |          |         |                 |
+------------------------------+----------+---------+-----------------+
| TOTAL AMOUNT ENCLOSED \$     |          |         |                 |
+------------------------------+----------+---------+-----------------+
|                              |          |         |                 |
+------------------------------+----------+---------+-----------------+
| Payment (check one): Visa    |          |         |                 |
| MasterCard AmEx Check/Money  |          |         |                 |
| Order                        |          |         |                 |
+------------------------------+----------+---------+-----------------+
| If you will be paying by     |          |         |                 |
| credit card please go to     |          |         |                 |
| this site to submit your     |          |         |                 |
| credit card information.     |          |         |                 |
| <https://cfwebpro            |          |         |                 |
| d.sandia.gov/cfdocs/ccpwa/>. |          |         |                 |
| **Make sure your pop-up      |          |         |                 |
| blocker is disabled** or     |          |         |                 |
| your payment will not get    |          |         |                 |
| processed.\                  |          |         |                 |
| If you do not receive a      |          |         |                 |
| confirmation receipt, please |          |         |                 |
| call Lynn Washburn.\         |          |         |                 |
| After submitting, please     |          |         |                 |
| print this registration form |          |         |                 |
| and mail/fax it to Lynn      |          |         |                 |
| Washburn (address below)     |          |         |                 |
+------------------------------+----------+---------+-----------------+
| **Make checks/money orders   |          |         |                 |
| payable to: Sandia National  |          |         |                 |
| Laboratories**\              |          |         |                 |
| **Send this form with        |          |         |                 |
| payment to:**\               |          |         |                 |
| Sandia National              |          |         |                 |
| Laboratories\                |          |         |                 |
| Attn: Jacqueline Finley\     |          |         |                 |
| P.O. Box 5800, MS-1319\      |          |         |                 |
| Albuquerque, NM 87185-1319   |          |         |                 |
|                              |          |         |                 |
| **or fax it to               |          |         |                 |
| 505-284-4520**\              |          |         |                 |
| \                            |          |         |                 |
| **For questions contact:     |          |         |                 |
| Jacqueline Finley at         |          |         |                 |
| 505-284-6969;**              |          |         |                 |
|                              |          |         |                 |
| **email:                     |          |         |                 |
| jafinle@sandia.gov**         |          |         |                 |
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