Mail or Fax

To register for the El Niño Workshop, please print out this page and mail or fax it to us.
El Niño Workshop, c/o Metasystems Design Group,
2000 North 15th Street, suite 103,
Arlington, VA 22201 USA

Phone: 703 243 6622,
Metasystems Design Group, Inc. Fax: 703-841-9798

I want to participate in the El Niño Workshop. My contact and payment information are detailed below:

Name and Mailing Address:

Name (required):

Title or position:

Organization:

Street address (or P.O. Box Number):

City:

State or Province:

Zip or postal code:

Country:

Voice phone (required):

Fax phone:

E-mail address (required):

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Method of payment (check one):

1. Charge my fees to my credit card, or

Amount : $30.00

2. Invoice my organization for my fees, or

3. Check or money order enclosed (in US dollars only).

Credit Card information:

Credit card type (check one):

Name on card:

Account number:

Expiration date:

Visa,

or MasterCard,

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or American

Express

 Billing Address: (if your organization will pay your fees)

Purchase order number, if applicable:

Name of person handling your accounts payable:

Organization:

Street address or PO Box number:

City:

State, Zip code:

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