Crash Day Registration

Registration

Registration

Crash Day 2009

Chemeketa Community College
4000 Lancaster Drive NE
Salem, Oregon 97309

June 19, 2009

Please complete this form and click “Submit” to register online. Online payments are available with PayPal, or print completed registration form and mail with your check to:

Oregon Chapter – IAISU

ATTN: Crash Day Registration

PO Box 1071

Lake Oswego, OR 97034

First Name: Last Name:

Organization:

Address:

City: State: Zip:

Phone: Email:

	Oregon IASIU Member - FREE Registration before May 15, 2009: Reserved for OR-IASIU members in good standing only.	FREE
	Non-Oregon IASIU Member - $50.00 Registration available after May 15, 2009. Pay online with PayPal or submit check payable to: Oregon Chapter - IASIU Tax ID: 93-1173312	$50.00