ISACA

ISACA New York Metropolitan Chapter

2003-2004 Chapter Educational Year

July 1, 2003 - June 30, 2004

GENERIC REGISTRATION FORM AND INVOICE

(revised 11/10/2003)

Please print, complete, and mail this form

Registrant:

Organization:

Address:

Phone: Fax:

e-Mail Address:

Event Date:

Event Name:

Member Cost . . . . . $ payment method: __Check, or Subscription Ticket #___________

Non-Member Cost . $ payment method: __Check

If the event includes a meal, please

note any special dietary requirements

This form can be used to reserve your attendance at any 2003-2004 Chapter Year Educational event.
Member pricing is for the sole benefit of current ISACA members in good standing.
If a non-member registers with member pricing, they must pay the difference between member and
non-member pricing prior to attending the event.

Make your check payable to:

(Your cancelled check will be your receipt)

ISACA New York Metropolitan Chapter, Inc.

Mail this form and your check to:

NY/ISACA
G.P.O. Box 1279
New York, NY 10116-1279

For questions, please contact: