Before July 28, 2005   Members $2,300  $   Non-members $2,600  $   Companion $  900 $ After July 28, 2005   Members $2,600  $   Additional Person Member Firm Discount* $2,300 X $   Non-members $2,900  $   Additional Person Non-member Firm Discount $2,600 X $   Companion $  900 $ After October 20, 2005   Member $2,850  $   Additional Person Member Firm Discount* $2,300 X $   Non-member $3,200  $   Additional Person Non-member Firm Discount $2,600 X $   Companion $  900 $   TOTAL [Payable is US dollars] $   Payment Information: First Name: Last Name: Title: Firm: Address: City: State: Zip Code: Country: Tel: Fax: Email: Nickname: Guest Full Name: Guest Nickname: Special Needs : Payment : Check enclosed Amex Diners Club MasterCard Visa Account Number: Exp. Name as it appears on card: Completed form may be faxed to: 1.212.551.7934