AMF Registration Form

AMF66, October 29-30, 2009

Fields marked with * are required.

Prefix *: Dr. Mr. Mrs. Miss Ms.

First Name *:

Last Name *:

Title *:

Affiliation/Company *:

Address 1 *:

Address 2:

City *:

State *: Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

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Thursday's dinner/dietary restriction: I will be attending Thursday evening's dinner I prefer a vegetarian meal for Thursday's dinner or I have a food allergy to:

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Included in your registration fee is your choice of ONE of the following books: Green Manufacturing: Case Studies in Leadership and Improvement by AME Green to Gold: How Smart Companies Use Environmental Strategy... by D. Esty, A.S. Winston Creating a Lean Culture: Tools to Sustain lean Conversions by David Mann Lean Six Sigma for Supply Chain Management by James William Martin

Registration fee is $495 per person *. LEAN method: pay by Mastercard, Visa or AmEx! Receipt emailed if email address is provided above. Mail form and check or money order (payable to Penn State University) to:

Call Carmen Strand at: (814)865-6727 with credit card information to complete your registration.

Carmen Strand CMTOC Penn State University 489 Business Building University Park, PA 16802

If you have questions, please contact: Carmen Strand, Research Assistant Center for the Management of Technological and Organizational Change Penn State University 489 Business Building University Park, PA 16802 Phone: 814-865-6727 Fax: 814-865-7064 Email: cms57@psu.edu