MIT Enterprise Forum Registration Form

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Please print this form from the website and complete and send it with credit card information or a check payable to "MITEF".

EVENT NUMBER PRICE TOTAL
Introduction to Business Planning
Apr. 2 May 7 Jun. 4 Jul. 9 Aug. 6 Sep. 10
(please check the evening you would like to attend)
  $20 / $20*  
Emerging Technologies That Will Change the World
Wednesday, June 20, 2001
  $30 / $50*  
*Note: 1st price is for members; 2nd is for nonmembers
I want to join MITEF to support New York's leading organization for entrepreneurs in technology. Please grant me the discounts and privileges of membership for an additional $100. $100  
  TOTAL →  

I am paying by:    Check made out to MITEF    Mastercard    Visa    Amex

Name as it appears on credit card _________________________________________________________

Credit Card No. ______________________________________________________ Exp. ____________

Signature ___________________________________________________________________________

Name _______________________________________________________ Title ___________________

Company ____________________________________________________________________________

Address ____________________________________________________________________________

City ________________________________________________ State ________ Zip ______________

Phone _________________ Fax _________________ E-mail __________________________________

How do you prefer to receive our newsletter and other announcements? Please check one:
Mail to Business*    Mail to Home*    E-Mail at Business    E-Mail at Home
*updates are faxed

Please tell us your professional business category (check the ones that most closely apply):
Financial Services (Corporate/Commercial/Institutional Finance, Investment Banking, Venture Capital)
Corporate Services (Accounting, Law, Consulting, Executive Search, Marketing/Advertising/PR)
Industry (Manufacturing, Telecom, Healthcare/Biotechnology)
Media (Internet/Software, Publishing, Broadcasting)
Other (specify) ____________________________
I own my own business.

I would rather NOT be listed in an Attendance Roster.

MIT Enterprise Forum of New York City - 317 Madison Avenue, Suite 1900 - New York, NY 10017
Telephone 212.681.1112 - Fax 212.286.9036