EyeforWireless 2004: Registration Form

To register for EyeforWireless 2004, please complete the online registration form below and submit your credit card details via our secure payment page.

If you have any questions, or would prefer to book over the telephone, please contact us by dialing:

1 800 814 3459 (toll-free USA) or +44 (0) 20 7375 7575

(* = required field)

* First Name:
* Last Name:
* Company:
* Job Title:
* Phone Number:
* E-mail Address:
* Address1:
Address2:
* City:
* State/Province:
* Zip/Postcode:
* Country:	Select One ...................................... France Germany Sweden United Kingdom USA ...................................... Australia Austria Belgium Canada China Czech Republic Denmark Finland France Germany India Ireland Israel Italy Japan Netherlands Norway Pakistan South Korea Spain Sweden Switzerland UK USA Other
I WOULD LIKE TO REGISTER FOR :
Click here for information on the different pass types and special offers Please note: No discount will be given for onsite registrations
Gold Pass:	2 day pass - $1195 (before March 19),           $1395 afterwards
Silver Pass:	1 day pass - $895
Group Pass:	Register 3 or more to claim your discounts
WISPs Pass:	Special discount pass - $995
Telecoms Pass:	Special discount pass - $695
Add you discount code:
* Yes, I agree to the terms and conditions
Please press the 'submit' button only once It may take a few seconds for your information to be uploaded.