UDI Plugfest Registration Form

Every participant must fill out a registration form in order to
attend the interop March 19-23, 2001, at Unisys in Salt Lake City.
Each company must submit a signed Confidentiality Agreement.

Please print and fax to (801) 594-5579, or mail to
Kevin Van Maren / Unisys / PO BOX 16800 / SLC, UT 84116


Name: _______________________________________________________________

Company: ____________________________________________________________

Address: ____________________________________________________________

         ____________________________________________________________

City: ____________________________   State: ______   Zip: ___________

Phone: ( ____ ) _____-_______        Fax: ( ____ ) _____-_______

Email: ______________________________________________________________


Circle dates attending:   3/19   3/20   3/21   3/22   3/23


Every attendee will be provided with a 110V power outlet, ports on a
10BaseT hub, and a table and chair.  Please indicate any additional
requests (additional space, 220V power, etc) below.

Special requirements: _______________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Please submit an equipment form entry for every computer or box
shipped or brought with your registration form (or later, if not
known when registering, as long as we receive it before the
equipment arrives).