|
Server : Apache/2.4.62 System : FreeBSD fbsdweb2.web.rcn.net 14.1-RELEASE FreeBSD 14.1-RELEASE releng/14.1-n267679-10e31f0946d8 GENERIC amd64 User : www ( 80) PHP Version : 8.3.8 Disable Function : NONE Directory : /domains/abtechsci/mmc15/HDWRegistrationAndLogin/ |
Upload File : |
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<!-- saved from url=(0045)http://www.clemson.edu/MMC-15/registernow.htm -->
<html xmlns="http://www.w3.org/1999/xhtml"><head><meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<title>MMC-15:2013 | Clemson University</title>
<style type="text/css">
<!--
body {
margin-left: 0px;
margin-top: 0px;
margin-right: 0px;
margin-bottom: 0px;
}
.style1 {
font-family: Arial, Helvetica, sans-serif;
font-size: 24px;
}
.style31 {
font-family: Arial, Helvetica, sans-serif;
font-size: 12px;
}
.style60 {font-family: Arial, Helvetica, sans-serif; font-size: 12px; font-weight: bold; }
.style61 {
font-family: Arial, Helvetica, sans-serif;
font-size: 14px;
font-weight: bold;
color: #640000;
}
-->
</style>
<script language="JavaScript" type="text/javascript" src="./registernowx130107_files/validatescripts.js.php"></script>
<style id="wrc-middle-css" type="text/css">
.wrc_whole_window{ display: none; position: fixed; z-index: 2147483647; background-color: rgba(40, 40, 40, 0.9); word-spacing: normal !important; margin: 0px !important; padding: 0px !important; border: 0px !important; left: 0px; top: 0px; width: 100%; height: 100%; line-height: normal !important; letter-spacing: normal !important; overflow: hidden;}.wrc_bar_window{ display: none; position: fixed; z-index: 2147483647; background-color: rgba(60, 60, 60, 1.0); word-spacing: normal !important; font-family: Segoe UI, Arial Unicode MS, Arial, Sans-Serif; margin: 0px !important; padding: 0px !important; border: 0px !important; left: 0px; top: 0px; width: 100%; height: 40px; line-height: normal !important; letter-spacing: normal !important; color: white !important; font-size: 13px !important;}.wrc_middle { display: table-cell; vertical-align: middle; width: 100%;}.wrc_middle_main { font-family: Segoe UI, Arial Unicode MS, Arial, Sans-Serif; font-size: 14px; width: 600px; height: auto; background: url(chrome-extension://icmlaeflemplmjndnaapfdbbnpncnbda/skin/images/background-body.jpg) repeat-x left top; background-color: rgb(39, 53, 62); position: relative; margin-left: auto; margin-right: auto; text-align: left;}.wrc_middle_tq_main { font-family: Segoe UI, Arial Unicode MS, Arial, Sans-Serif; font-size: 16px; width: 615px; height: 460px; background: url(chrome-extension://icmlaeflemplmjndnaapfdbbnpncnbda/skin/images/background-sitecorrect.png) no-repeat; background-color: white; color: black !important; position: relative; margin-left: auto; margin-right: auto; text-align: center;}.wrc_middle_logo { background: url(chrome-extension://icmlaeflemplmjndnaapfdbbnpncnbda/skin/images/logo.jpg) no-repeat left bottom; width: 140px; height: 42px; color: orange; display: table-cell; text-align: right; vertical-align: middle;}.wrc_icon_warning { margin: 20px 10px 20px 15px; float: left; background-color: transparent;}.wrc_middle_title { color: #b6bec7; height: auto; margin: 0px auto; font-size: 2.2em; white-space: nowrap; text-align: center;}.wrc_middle_hline { height: 2px; width: 100%; display: block;}.wrc_middle_description { text-align: center; margin: 15px; font-size: 1.4em; padding: 20px; height: auto; color: white; min-height: 3.5em;}.wrc_middle_actions_main_div { margin-bottom: 15px; text-align: center;}.wrc_middle_actions_blue_button div { display: inline-block; width: auto; cursor: Pointer; margin: 3px 10px 3px 10px; color: white; font-size: 1.2em; font-weight: bold;}.wrc_middle_actions_blue_button { -moz-appearance: none; border-radius: 7px; -moz-border-radius: 7px/7px; border-radius: 7px/7px; background-color: rgb(0, 173, 223) !important; display: inline-block; width: auto; cursor: Pointer; border: 2px solid #00dddd; padding: 0px 20px 0px 20px;}.wrc_middle_actions_blue_button:hover { background-color: rgb(0, 159, 212) !important;}.wrc_middle_actions_blue_button:active { background-color: rgb(0, 146, 200) !important; border: 2px solid #00aaaa;}.wrc_middle_actions_grey_button div { display: inline-block; width: auto; cursor: Pointer; margin: 3px 10px 3px 10px; color: white !important; font-size: 15px; font-weight: bold;}.wrc_middle_actions_grey_button { -moz-appearance: none; border-radius: 7px; -moz-border-radius: 7px/7px; border-radius: 7px/7px; background-color: rgb(100, 100, 100) !important; display: inline-block; width: auto; cursor: Pointer; border: 2px solid #aaaaaa; text-decoration: none; padding: 0px 20px 0px 20px;}.wrc_middle_actions_grey_button:hover { background-color: rgb(120, 120, 120) !important;}.wrc_middle_actions_grey_button:active { background-color: rgb(130, 130, 130) !important; border: 2px solid #00aaaa;}.wrc_middle_action_low { font-size: 0.9em; white-space: nowrap; cursor: Pointer; color: grey !important; margin: 10px 10px 0px 10px; text-decoration: none;}.wrc_middle_action_low:hover { color: #aa4400 !important;}.wrc_middle_actions_rest_div { padding-top: 5px; white-space: nowrap; text-align: center;}.wrc_middle_action { white-space: nowrap; cursor: Pointer; color: red !important; font-size: 1.2em; margin: 10px 10px 0px 10px; text-decoration: none;}.wrc_middle_action:hover { color: #aa4400 !important;}a:link {
text-decoration: none;
color: #0000CC;
}
a:visited {
text-decoration: none;
}
a:hover {
text-decoration: none;
color: #FF9900;
}
a:active {
text-decoration: none;
}
.style62 {font-size: 14px}
.style63 {
font-size: 14px;
font-family: Arial, Helvetica, sans-serif;
font-weight: bold;
}
.style64 {
color: #000066;
font-style: italic;
}
</style><script id="wrc-script-middle_window" type="text/javascript" language="JavaScript">var g_inputsCnt = 0;var g_InputThis = new Array(null, null, null, null);var g_alerted = false;/* we test the input if it includes 4 digits (input is a part of 4 inputs for filling the credit-card number)*/function is4DigitsCardNumber(val){ var regExp = new RegExp('[0-9]{4}'); return (val.length == 4 && val.search(regExp) == 0);}/* testing the whole credit-card number 19 digits devided by three '-' symbols or exactly 16 digits without any dividers*/function isCreditCardNumber(val){ if(val.length == 19) { var regExp = new RegExp('[0-9]{4}-[0-9]{4}-[0-9]{4}-[0-9]{4}'); return (val.search(regExp) == 0); } else if(val.length == 16) { var regExp = new RegExp('[0-9]{4}[0-9]{4}[0-9]{4}[0-9]{4}'); return (val.search(regExp) == 0); } return false;}function CheckInputOnCreditNumber(self){ if(g_alerted) return false; var value = self.value; if(self.type == 'text') { if(is4DigitsCardNumber(value)) { var cont = true; for(i = 0; i < g_inputsCnt; i++) if(g_InputThis[i] == self) cont = false; if(cont && g_inputsCnt < 4) { g_InputThis[g_inputsCnt] = self; g_inputsCnt++; } } g_alerted = (g_inputsCnt == 4); if(g_alerted) g_inputsCnt = 0; else g_alerted = isCreditCardNumber(value); } return g_alerted;}function CheckInputOnPassword(self){ if(g_alerted) return false; var value = self.value; if(self.type == 'password') { g_alerted = (value.length > 0); } return g_alerted;}function onInputBlur(self, bRatingOk, bFishingSite){ var bCreditNumber = CheckInputOnCreditNumber(self); var bPassword = CheckInputOnPassword(self); if((!bRatingOk || bFishingSite == 1) && (bCreditNumber || bPassword) ) { var warnDiv = document.getElementById("wrcinputdiv"); if(warnDiv) { /* show the warning div in the middle of the screen */ warnDiv.style.left = "0px"; warnDiv.style.top = "0px"; warnDiv.style.width = "100%"; warnDiv.style.height = "100%"; document.getElementById("wrc_warn_fs").style.display = 'none'; document.getElementById("wrc_warn_cn").style.display = 'none'; if(bFishingSite) document.getElementById("wrc_warn_fs").style.display = 'block'; else document.getElementById("wrc_warn_cn").style.display = 'block'; warnDiv.style.display = 'table'; } }}</script></head>
<body>
<table width="645" border="0" cellpadding="10" cellspacing="0">
<tbody>
<tr>
<td height="576"><form action="http://www.abtechsci.com/mmc15/HDWRegistrationAndLogin/RegistrationAndLogin.php" method="post" name="mmc-15reg" id="mmc-15reg" onsubmit="return HDW_validate_registration(this)">
<label></label>
<table class="personal_table">
<tbody>
<tr>
<td height="27" colspan="2" bgcolor="#E2E2E2" class="style61">Pre-registration required prior to payment and / or abstract submission </td>
</tr>
<tr>
<td height="27" colspan="2" bgcolor="#E2E2E2" class="style60"><table width="614" height="27" border="0" cellpadding="0">
<tr>
<td width="419">Please select a username and password.</td>
<td width="189">(*Reqiured fields)</td>
</tr>
</table></td>
</tr>
<tr>
<td width="198" class="style31">Username*</td>
<td width="415" class="style31"><input type="text" name="username" /></td>
</tr>
<tr>
<td class="style31">Password*</td>
<td class="style31"><label>
<input type="text" name="Password" />
</label></td>
</tr>
<tr>
<td class="style31">Password again*</td>
<td class="style31"><label>
<input type="text" name="Password again" />
</label></td>
</tr>
<tr bgcolor="#E2E2E2">
<td height="31" colspan="2" class="style60">Personal Information:</td>
</tr>
<tr>
<td class="style31">Attendee's FIRST NAME*</td>
<td class="style31"><input name="firstname" type="text" />
LAST NAME*
<input name="lastname" type="text" /> </td>
</tr>
<tr>
<td class="style31">First Time Attending?</td>
<td class="style31"><select name="first_time" class="small">
<option value="Yes">Yes</option>
<option value="No" selected="selected">No</option>
</select> </td>
</tr>
<tr>
<td class="style31">Your Affiliation?* </td>
<td class="style31"><select name="affiliation">
<option value="" selected="selected">Select from list</option>
<option value="University">University</option>
<option value="Industry">Industry</option>
<option value="Foundation">Foundation</option>
<option value="Nat_lab">National / Government Laboratory</option>
<option value="Other">Other</option>
</select></td>
</tr>
<tr>
<td class="style31">Title</td>
<td class="style31"><input name="title" class="short" type="text" /> </td>
</tr>
<tr>
<td class="style31">Preferred Name</td>
<td class="style31"><input name="preferred_name" type="text" /> </td>
</tr>
<tr>
<td class="style31">Organization*</td>
<td class="style31"><input name="organization" type="text" /> </td>
</tr>
<tr>
<td class="style31">Street Address*</td>
<td class="style31"><input name="street_address" type="text" /></td>
</tr>
<tr>
<td class="style31">City*</td>
<td class="style31"><input name="city" type="text" /> </td>
</tr>
<tr>
<td class="style31">State /.Province*</td>
<td class="style31"><input name="state" type="text" /></td>
</tr>
<tr>
<td class="style31">Zip / Post Code*</td>
<td class="style31"><input name="zip" class="small" type="text" /></td>
</tr>
<tr>
<td class="style31">Country*</td>
<td class="style31"><label>
<select name="Country">
<option value="" selected="Selected">Select Country</option>
<option value="United States">United States</option>
<option value="United Kingdom">United Kingdom</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, The Democratic Republic of The">Congo, The Democratic Republic of The</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote D'ivoire">Cote D'ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-bissau">Guinea-bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and Mcdonald Islands">Heard Island and Mcdonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran, Islamic Republic of">Iran, Islamic Republic of</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
<option value="Korea, Republic of">Korea, Republic of</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Macedonia, The Former Yugoslav Republic of">Macedonia, The Former Yugoslav Republic of</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
<option value="Moldova, Republic of">Moldova, Republic of</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="Netherlands Antilles">Netherlands Antilles</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Helena">Saint Helena</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and The Grenadines">Saint Vincent and The Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia and Montenegro">Serbia and Montenegro</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia and The South Sandwich Islands">South Georgia and The South Sandwich Islands</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
<option value="Thailand">Thailand</option>
<option value="Timor-leste">Timor-leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Venezuela">Venezuela</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
</label></td>
</tr>
<tr>
<td class="style31">Phone Arera Code/Counrty Code*</td>
<td class="style31"><input name="phone_area_code" type="text" size="16" />
<label></label>
<br /></td>
</tr>
<tr>
<td class="style31">Phone or Cell Number*</td>
<td class="style31"><input name="phone_number" type="text" />
<label></label>
<br /></td>
</tr>
<tr>
<td class="style31">Email Address*</td>
<td class="style31"><input name="email_address" type="text" /> </td>
</tr>
<tr>
<td class="style1"> </td>
</tr>
<tr>
<td colspan="2" class="style31"><small>Spouses of attendees are welcome to complete a <strong><u>SEPARATE</u></strong> registration for the
conference at a reduced rate. Registered spouses can enjoy all of the workshops,
meals, events and happenings at the MMC-15 Biannual Conference, including the Banquet.</small></td>
</tr>
<tr>
<td class="style31">Spouse's FIRST NAME</td>
<td class="style31"><input name="spousefirstname" type="text" />
LAST NAME
<input name="spouselastname" type="text" /> </td>
</tr>
<tr>
<td class="style31">Spouse�s Email Address</td>
<td class="style31"><input id="spouse_email" name="spouse_email" type="text" /> </td>
</tr>
<tr>
<td class="style31"> </td>
<td class="style31"> </td>
</tr>
<tr bgcolor="#E2E2E2">
<td height="26" colspan="2" class="style31"><strong>Registrations </strong><em>(totals displayed in cart and checkout screens) </em></td>
</tr>
</tbody>
</table>
<table width="585" class="smart_table">
<colgroup>
<col />
<col />
<col />
<col width="80px" />
<col />
</colgroup>
<tbody>
<tr>
<td width="145" class="style31"><input class="first_representative_registration sum_qty" id="first_representative_registration" name="registration_type" value="first_representative_registration" type="radio" /></td>
<td width="28" class="style31">$628</td>
<td width="268" class="style31">MMC-15 Standard Delegate Registration<br /> </td>
<td width="69" class="style31"> </td>
<td width="51" class="registration_subtotal reg_type style1"></td>
</tr>
<tr>
<td class="style31"><input class="non-ABACC_registration sum_qty" id="non-ABACC_registration" name="registration_type" checked="checked" value="non-ABACC_registration" type="radio" /> </td>
<td class="style31">$520</td>
<td class="style31">MMC-15 Author / Academic Delegate Registration</td>
<td class="style31"> </td>
<td class="style31"> </td>
</tr>
</tbody>
<tbody><tr>
<td class="style31"><input class="first_representative_registration sum_qty" id="radio" name="registration_type" value="first_representative_registration" type="radio" /></td>
<td class="style31">$210</td>
<td class="style31">MMC-15 Student Delegate Registration<br /> </td>
<td class="style31"> </td>
<td class="registration_subtotal reg_type style1"></td>
</tr>
<tr>
<td class="style31"><input class="first_representative_registration sum_qty" id="radio2" name="registration_type" value="first_representative_registration" type="radio" /></td>
<td class="style31">$250</td>
<td class="style31">MMC-15 Spouse Registration</td>
<td class="style31"> </td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><input class="discount_special discount_code" name="discount_code" id="discount_code" style="width: 80px;" type="text" /> </td>
<td class="style1"> </td>
<td class="style31">Applicable Discount Code</td>
<td class="style31"> </td>
<td class="style31" style="color: green;"> </td>
</tr>
<tr bgcolor="#E2E2E2">
<td height="26" colspan="5" class="style60">OPTIONAL ACTIVITIES </td>
</tr>
<tr>
<td class="style31"><label>
<input name="submit_abstract" type="radio" value="Yes" />
Yes </label>
<label>
<input name="submit_abstract" type="radio" value="No" />
No </label></td>
<td class="style31"> </td>
<td class="style31">Are you submitting an Abstract? (PLEASE SEE BELOW)</td>
<td class="style31"> </td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><label>
<input name="submit_abstract_type" type="radio" value="Poster" />
Poster </label>
<label>
<input name="submit_abstract_type" type="radio" value="Oral" />
Oral </label></td>
<td class="style31"> </td>
<td class="style31">Abstract Type</td>
<td class="style31"> </td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><label>
<input name="visa_application_letter" type="radio" value="Yes" />
Yes </label>
<label>
<input name="visa_application_letter" type="radio" value="No" />
No </label></td>
<td class="style31"> </td>
<td class="style31"> Is an official US entry visa application letter required following your PAID registration? </td>
<td class="style31"> </td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><input class="cpe_credits_participant sum_qty sum_checkbox" id="cpe_credits_participant" name="cpe_credits_participants" value="1" type="checkbox" /> </td>
<td class="style31">$25</td>
<td class="style31"><a href="http://www.milb.com/index.jsp?sid=t428" target="_blank">Local Baseball Game</a></td>
<td class="style31"> </td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><input class="registering_spouse sum_qty sum_checkbox" id="registering_spouse" name="spouse" value="1" type="checkbox" /> </td>
<td class="style31">$5</td>
<td class="style31"><a href="http://www.bmwusfactory.com/zentrum/" target="_blank">BMW Factory Tour</a></td>
<td class="style31"> </td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><input class="registering_business360 sum_qty sum_checkbox" id="registering_business360" name="business360" value="1" type="checkbox" /></td>
<td class="style31">$59</td>
<td class="style31">Golf: Clemson's <a href="http://www.clemson.edu/centers-institutes/madren/golf/" target="_blank">Walker Course</a> </td>
<td class="style31"> </td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td class="style31"><input class="registering_business360 sum_qty sum_checkbox" id="registering_business360" name="business360" value="1" type="checkbox" /> </td>
<td class="style31">$25</td>
<td class="style31"><a href="http://www.clemson.edu/MMC-15/Local_Activities.html">Recreational Boating</a> on Lake Hartwell</td>
<td class="style31"> </td>
<td class="registration_subtotal style1"></td>
</tr>
<tr>
<td height="32" class="style31"><input class="banquet_guests sum_qty" id="banquet_guests" name="banquet_guests" type="text" /> </td>
<td class="style31">$75</td>
<td class="style31">Banquet Guest Tickets�Each registration receives one complimentary
ticket. Additional guests are $75 each.</td>
<td class="style31"> </td>
<td class="style31"> </td>
</tr>
</tbody></table>
<hr />
<table width="524" cellspacing="px">
<tbody>
<tr>
<td colspan="5" class="style31"><p><strong>Special Conference Events</strong><br />
These are scheduled for Wednesday during the period noon - 5:00 p.m.<br />
Select only ONE special event.</p> </td>
</tr>
<tr>
<td width="42" class="style31"><input class="radio_button" name="abhe_team_training" value="1" type="radio" /></td>
<td colspan="3" class="style1"><strong class="style60">BioDot�s � Hands-on Polymer Printing Workshop</strong> </td>
<td width="89" class="style1"> </td>
<td width="63" class="style31"><em><strong>FREE</strong></em></td>
</tr>
<tr>
<td class="style31"><input class="radio_button" name="abhe_team_training" value="1" type="radio" /> </td>
<td colspan="3" class="style1"><strong class="style60">Tour of Milliken�s Fiber Processing Facility</strong></td>
<td class="style1"> </td>
<td class="style31"><em><strong>FREE</strong></em></td>
</tr>
</tbody>
</table>
<h4 class="style31">
<p class="style31"><strong>NOTE:</strong> Please carefully review your submission before clicking "Register." </p>
</h4>
<p class="style63 style64">Thank you for providing your registration information. You must now proceed to on-line payment of your registration fee to complete your registration.</p>
<p>
<input name="option" value="com_conferenceregistration" type="hidden" />
<input name="view3" value="default" type="hidden" />
<input name="task" value="register" type="hidden" />
<input name="option2" value="com_conferenceregistration" type="hidden" />
<input name="view2" value="default" type="hidden" />
<input name="task2" value="register" type="hidden" />
<input name="option" value="com_conferenceregistration" type="hidden" />
<input name="view" value="default" type="hidden" />
<input name="task" value="register" type="hidden" />
<input name="submit" type="submit" value="Register and continue with payment" />
</span>
</p>
</p>
<h4 class="style31">
<input type="hidden" name="hdwtablename" id="hdwtablename" value="1" />
<input type="hidden" name="hdwusername" id="hdwusername" value="username" />
<input type="hidden" name="hdwpassword" id="hdwpassword" value="Password" />
<input type="hidden" name="hdwconfirm" id="hdwconfirm" value="Password again" />
<input type="hidden" name="hdwfirstname" id="hdwfirstname" value="firstname" />
<input type="hidden" name="hdwlastname" id="hdwlastname" value="lastname" />
<input type="hidden" name="hdwaffiliation" id="hdwaffiliation" value="affiliation" />
<input type="hidden" name="hdworganization" id="hdworganization" value="organization" />
<input type="hidden" name="hdwstreet_address" id="hdwstreet_address" value="street_address" />
<input type="hidden" name="hdwcity" id="hdwcity" value="city" />
<input type="hidden" name="hdwstate" id="hdwstate" value="state" />
<input type="hidden" name="hdwzip" id="hdwzip" value="zip" />
<input type="hidden" name="hdwCountry" id="hdwCountry" value="Country" />
<input type="hidden" name="hdwphone_number" id="hdwphone_number" value="phone_number" />
<input type="hidden" name="hdwok" id="hdwok" value="register-success.html" />
<input type="hidden" name="hdwemail" id="hdwemail" value="[email protected]" />
<input type="hidden" name="hdwnook" id="hdwnook" value="register-failed.html" />
<input type="hidden" name="hdwactivation_email" id="hdwactivation_email" value="email_address" />
</h4>
</form></td>
</tr>
<tr>
<td width="645" height="42"><table width="583" border="0" cellpadding="6">
<tr background="abstract_back.png">
<td width="575" height="29"><div align="center"><a href="Abstract_Submission.html" target="_blank" class="style31 style62"><strong>PLEASE SUBMIT ABSTRACTS PRIOR TO PAYMENT HERE</strong></a><br />
<span class="style31"><strong>(This link will open a new browser window, after abstract upload <br />
please close
the window to return here to continue with payment)</strong></span></div></td>
</tr>
</table></td>
</tr>
</tbody>
</table>
</body></html>