JUNBA 2008 Registration Form
I will attend JUNBA Symposium on January 10th, 2008 No Yes
I will attend JUNBA Technology Fair on January 11th, 2008 No Yes
Prefix Prefix Dr. Ms. Mr.
First Name
Last Name
Job Title
Company/Affiliation
Street Address 1
Street Address 2
City
State
Zip or Postal Code
Phone
E-Mail
Re-type E-Mail
Please make sure that your email addresses match and are correct. Your email address will be used to confirm your registration as well as to exchange any further correspondence with you.