Vendor Form for CCSC:SE Conference

November 7-8, 2008

Augusta State University

Augusta, GA

Please make your check payable to CCSC for the amount of $50. Mail your check along with this form to Dr. John Stamey at:

Department of Computer Science

Coastal Carolina University

Conway, SC 29528

jwstamey@coastal.edu

843-349-2552

Company Name ________________________________

Contact Person _________________________________

Address _______________________________________

_______________________________________

_______________________________________

Telephone _____________________________________

E-mail ________________________________________

Number of people attending:

Any special requirements?

_______________________________________________________________________

________________________________________________________________________

________________________________________________________________________

If you are interested in attending the conference banquet or luncheon, please include $25 per ticket to the banquet and/or $10 per ticket to the luncheon in your payment.