Access '96
Innovative Technology in Libraries

Monday, September 30 - Wednesday, October 2, 1996
Simon Fraser University at Harbour Centre
Vancouver, BC Canada

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REGISTRATION FORM

ATTENDEE INFORMATION:

        First Name: ____________________________________

         Last Name: ____________________________________            
 
             Title: ____________________________________

      Organization: ____________________________________

    Street Address: ____________________________________

                    ____________________________________

Mail Stop/Room No.: ____________________________________

              City: ____________________________________

    Province/State: ___________________  

   Postal/ZIP code: ___________________ 

             Phone: ___________________                 

               Fax: ___________________

    E-mail Address: ___________________ 

CONFERENCE FEES (includes conference registration and social events):

$150.00 Cdn.(Special rate for members of BCLA and CLA 
                Emerging Technologies Interest Group)
$200.00 Cdn.(other)

PAYMENT METHOD:

Cheque or money order
    (please make cheques payable to the OPEN LEARNING AGENCY)
Visa
Mastercard

Credit card authorization

I authorize the Open Learning Agency to charge the above 
conference registration fees to my credit card:

 CREDIT CARD NUMBER: ___________________________ 

NAME ON CREDIT CARD: ___________________________ 

       EXPIRY DATE: ___________________________

          SIGNATURE: ___________________________ 

Receipt required?

Yes No

Please complete and mail or fax to:

Access '96 Conference Registration
Electronic Library Network
Open Learning Agency
4355 Mathissi Place
Burnaby, British Columbia
Canada
V5G 4S8

  FAX: (604)431-3381
PHONE: (604)431-3020


THANK YOU