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              |  | The National SBIR/STTR Conference Hyatt Regency Albuquerque Hotel
 Albuquerque, NM
 March 11 - 14, 2003
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              |  | On-site Registration Form |  |  | 
    
      | Dr/Mr/Mrs/Ms:_____________________________________________________________________________________ | 
    
      | Badge Name: (if different)___________________________________________________________________________ | 
    
      | Company:________________________________________________________________________________________ | 
    
      |  | 
    
      | City/State/Zip:_____________________________________________________________________________________ | 
    
      | Phone:__________________________________________________Fax:_____________________________________ | 
    
      | Email:___________________________________________________________________________________________ | 
    
      |  | 
    
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            | Selection | Conference Registration Fee(s): |  |  
            |  | FULL REGISTRATION | $400 |  
            |  | 
                Wednesday, March 12 (Includes Tuesday Welcome Reception)
 | $175 |  
            |  | 
                Thursday, March 13
               | $150 |  
            |  | 
                Friday, March 14
               | $75 |  
            |  | Additional Workshops held on Friday, March 14, 2003: 
 | Fee |  
            |  | Workshop #2: Basic Accounting for Government Contracts: 1:00pm-3:00pm | $35 |  
            |  | Workshop #3: Three Pieces of the Puzzle!: 1:00pm-3:00pm | $35 |  
            |  | Workshop #4: Winning Phase III SBIR Awards/Challenging "Bundled" Contracts: 1:00pm-4:00pm | $75 |  
            |  | Total Amount Due: |  |  | 
    
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            | Please indicate method of payment: |  
            | ___Cash |  
            | Credit Card: _____VISA    _____Mastercard    _____American Express
 |  
            | Please Answer the Following Questions:
 |  
            | 
                
                  Number of Employees at your Company Location:___2-5 ___6-19 ___20-49 ___50-99 ___100-249 ___250-499 ___500+
                  Which of the following describes your main area of interest? Check ONE:___BioTech ___Communications ___Computers ___Electronics  ___Energy
 ___Environmental Tech ___Information Technologies ___Optics/Photonics
 ___Life Sciences ___Materials ___Mechanics  Other:_____________________________________________
                  ____Please indicate if you need special assistance to participate.____Do you have special dietary needs? Explain:__________________________________________
Check if you are a past: ___ SBIR Phase I Winner ___ SBIR Phase II Award Winner |  
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