University of Oklahoma OUTREACH ~ Laurance Reid Gas Conditioning Conference REGISTRATION FORM

56th Annual Laurance Reid Gas Conditioning Conference

February 26 - March 1, 2006

Standard Registration Form
(Print off this form and then mail or fax in lieu of registering online)
557 0081 501

FEE: $350.00

Mail registration to:
CCE Registration ~ The University of Oklahoma
1700 Asp Avenue ~ Norman, OK 73072-6400

Fax your registration to:
(405) 325-7164

Or call: (405) 325-2248

Mr. Ms. Dr.________________________________________________________
Last First M.I.

SS Number:_______________________________________________________

Home Address_____________________________________________________

_________________________________________________________________
City State Zip

Company_________________________________________________________

Address__________________________________________________________
Street Address

________________________________________________________________
City State Zip

__________________________
Country

Home Phone__________________________ Work Phone______________________

Check One:
______Participant ______ Presenter ______ Committee Member

Please make checks payable to UNIVERSITY OF OKLAHOMA.

____ Check
____ VISA
____ MasterCard
____ Discover

Credit Card No. _________________________________ Exp. Date _______

All payments must be made in U.S. funds.

__ Please bill my company or agency. A copy of the purchase order or letter of authorization is attached.

__ The College of Continuing Education is committed to making its activities as accessible as possible. The College and the University provide a range of special services for persons with disabilities. If you anticipate a need for some of these services, please indicate this by checking this item.

Participant Signature:___________________________________________

Date: _______________________________________________________