Registration Form

“Injection Molding Topics”

Service Support Center – TSTC

May 11-12, 2004

Name: ____________________________________________________________

Company or School:_________________________________________________

Address:__________________________________________________________

City and State:______________________________________ Country:________

Telephone Number:_________________________________

e-mail address:_____________________________________

Fees:

Student: $20.00 U.S.

All Others: $200.00 U.S.

Make checks payable to “LRGV SPE”

(no credit cards accepted)

Fax, e-mail, or mail this form and payment to:

Karla Montejano

Texas State Technical College

1902 North Loop 499 – Building K

Harlingen, Texas 78550

Fax: 956-364-5142

For information or questions, please call or write to:

Oscar Garcia at 361-668-3969 or oscar.garcia@ticona.com

Art Palos at 956-687-9335 or artpalos@worldnet.att.net

Bob Stelzer at 956-364-4543 rstelzer@harlingen.tstc.edu