ASSIST Annual Convention 2002

October 3 - 4 - 5     �     Holiday Inn NASA     �     Houston, Texas

Cancellation Policy: Refunds, less a $30 processing fee per person, will be granted if requested in writing and received prior
to September 1, 2002. After September 1, 2002, no refunds will be made. ASSIST reserves the right to make necessary
modifications to the program/agenda.

I have read the Cancellation Policy and wish to attend the ASSIST 2002 Annual Convention:

Name __________________________________________________________________________________________________

Company Name __________________________________________________________________________________________

Address _________________________________________________________________________________________________

City, State, Zip ___________________________________________________________________________________________

Phone ____________________________  Fax _____________________________  E-mail ______________________________

Spouse/Guest Name _______________________________________________________________________________________

Fee Enclosed:  (Important: All registration forms must be received by September 28, 2002).

 ______ $175 ASSIST Member or $200 Non-member

 ______      * Mark Yes or No to indicate your plan to attend the Friday Night Dinner Cruise (*Fee is included in registration)

 ______ $ 80 Spouse/Guest (Those wishing to attend speaker functions for CE Credit should register as member or non-member)

 ______      * Mark Yes or No to indicate your plan to attend the Friday Night Dinner Cruise (*Fee is included in registration)

 ______ $150 Regular 2002 Voting Membership Dues (if not yet paid)

 ______ $ 65 Golf Tournament (Thursday, October 3)

 ______ $ 15 Per Child - Children's NASA Trip (1st Child attends free - each additional child $15)

$_________ Total Enclosed

(   )  I cannot attend, but would like to receive ASSIST Membership Information.

Make checks payable to:  Houston ASSIST  -  P.O. Box 27321  -  Houston, TX 77227

For Information, Call:  Convention - Ann Ball (713) 526-7171     Registration - Phyllis Grimes (713) 724-3515