Standardization of Broadband Over Power Line Technologies

Meeting Registration Form

20-21 July 2004

IEEE, Piscataway, New Jersey

Dates

Tuesday, 20 July, 9:00 am – 5:00 pm

Wednesday, 21 July, 8:00 am – 12:00 pm

Location

IEEE

445 Hoes Lane

Piscataway, New Jersey 08854 USA

Conference Room: Ada B

Meeting Registration Fee - $100 (Fee covers workshop, lunch, and coffee breaks)

To register for this meeting, please complete the information below, including payment method, and send to Tina Alston, IEEE staff, either by fax (732-562-1571) or e-mail (t.alston@ieee.org).

Hotel Information:

Embassy Suites - IEEE Rate $99
121 Centennial
Piscataway, NJ 08854
(800)-362-2779
(732)-980-0500

Name: _________________________________________________________________

Company: ______________________________________________________________

Address: _______________________________________________________________

Phone: _______________________ E-mail: __________________________________

Payment Method: Please circle one - (Visa, MasterCard, American Express, Cash or Check) _______________________________________________________________________