FOR OFFICE USE ONLY

 ID #

Date Rec'd:

Date Proc'd:

Colloquium for Information Systems Security Education (CISSE)

REGISTRATION FORM - CONFERENCE 2003

Dates: June 2-5, 2003       June 2, Boot Camp      June 3-5 Colloquium
Location: The Washington Marriott Hotel, 1221 22nd Street NW, Washington DC
Cost - Conference registration fee is $250
Registration fee not refundable after April 15, 2003; 25.00 service fee.
The price of the conference includes continental breakfast, dinner, banquet, breaks, and all materials.

Lodging Reservations may be made separately by calling the Washington Marriott at:
202.872.1500
For the hotel's address and transportation, see the Washington Marriott
Ask for the CISSE7 special rate: $145 nightly available for reservations received before May1
Please print and complete only ONE registration form per person. Please print clearly in ink.    
Last Name: _____________________________________      First Name: __________________

Position or Title:_______________________      Organization: _____________________________
Address:_______________________________________________________
___________________________________________________________________________
City:________________________________    State:_______     Zip: ____________________
Phone Number ( _____ )_____ _________    E-mail Address: ____________________________
____ Industry
____ Academia          ____ Government
        __ Yes, I will attend Boot Camp         __ No, I do not plan to attend Boot Camp

NOTE: All fields MUST BE COMPLETED before application will be processed.

Payment Options: Registration considered official upon receipt of one of the following payment methods.

Method of Payment:
Check ONE.   Make checks payable to: JMU/CISSE 2003.   JMU's Federal ID# 54-6001756

__ VISA       __ Mastercard     __ Discover      __ Check      __ Purchase Order

Name of Cardholder: ______________________________ Check # ___________ P.O. # ____________

Acct. Number: ________________________________ Exp. Date: __________ TOTAL: $____________

Mail registration form and payment to: CISSE Conf 2003, JMU Events and Conferences, MSC 3501, Harrisonburg VA 22807.   Make checks payable to: JMU/CISSE 2003.
No refunds will be given unless requested, IN WRITING, on or before: April 15, 2003; $25 service fee.
Registration questions, contact Bonnie Powell at 540-568-8043 or powellbs@jmu.edu
Program questions, contact Allan Berg at 540-568-8773 or bergax@jmu.edu
If you need to make special arrangements due to a disability of any type, please contact Bonnie Powell at powellbs@jmu.edu
James Madison University, Office of Events & Conferences

This form may be faxed if paying by Credit Card or organization Purchase Order to 540-568-6444.
The organization Purchase Order must be faxed with this form.