Vermont Information Technology Center

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Event Registration Form

[Please complete the form]

Friday • August 08, 2008

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Vermont Information Technology Center
Champlain College
163 South Willard St.
Burlington, VT 05401

Tel: (802) 865-6439
Fax: (802) 865-6447
Email: vitc@champlain.edu

Please Note: Items in green are required fields.
Event Name / Date:
Company Name:
Your Name:
Address:
City:
State:
Zip:
Business Phone:
Home Phone:
Email:
Web Address:
Comments?
Do you have any special needs?
Payment:	Check Mastercard Visa American Express
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Submitting Instructions:

Please make checks payable to:
Vermont Information Technology Center

If you would like to register via mail or fax, print this form and:

fax to: 802-865-6447

or mail to:

Event Registration
Vermont Information Technology Center
Champlain College
163 South Willard St.
Burlington, Vermont 05401