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CISA
/ CISM Recognition & Past Presidents Event
January
27, 2005
REGISTRATION
FORM AND INVOICE
Please
print, complete, and mail this form to the address below.
Registrant:
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ISACA
Member Number:
or, ___ Non-Member |
Organization:
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Address:
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City:
State:
ZIP: |
Phone:
Fax: |
e-Mail
Address: |
No
cost for:
I
passed the CISA _____ I passed the CISM ______ I am a past
president _____
If
no payment is necessary you may email the above information
to naomi.bodek@isacany.org
instead of mailing in the form. |
Member
Cost $50 _____
Checks
Only Please! We currently do not accept credit cards!
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Non-Member
& non-ISACANY Member Cost $ 100 _____
Checks
Only Please! We currently do not accept credit cards!
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Please note
any special dietary requirements: |
All
registration forms & payments must be received
by Monday, January 24th.
•
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.
Please
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 :
ISACA
NY Metro
G.P.O. Box 1279
New York, NY 10116-1279
For
questions, please contact:
Naomi
Bodek at 212-314-5392 / Naomi.Bodek@isacany.org
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