VTIC2000 REGISTRATION FORM


Please fill out the following form and click Submit. Fields in Bold are required for us to process your registration form.


Full Name:
 
Title (Mr., Mrs., Ms., Dr., Prof.)
  First
  Last           
M.I

Employer or School Name and Address:
 Name
 Street
 
City, State, Zip Code
 
Country (Required)

Telephone Number:
 Work
 Home
E-Mail Address:
  (Required)



Registration Fee

Please submit the registration online. If you are required to pay, please make check payable to VTIC2000 and send payment together with the printed registration form to:

VTIC2000 - C/O: Dr. Thuy T. Le
Electrical Engineering Department, ENGR377
San Jose State University
One Washington Square
San Jose, CA 95192-0084
E-mail:
thuytle@email.sjsu.edu