<p>Please complete the information requested below. You do not have to send your Credit Card information this year. Completed registration forms should be sent to your 2017 ECCO Treasurer, [email protected].</p><p>Once I will receive you registration form, I will send you a “PayPal” Invoice that will allow you to pay on- line with your own Credit Card. You do NOT have to have a PayPal account to pay.</p><p>Name: _ </p><p>Affiliation: </p><p>Address: </p><p>City: State: Zip: </p><p>Phone: ( ) - Fax: ( ) - </p><p>Em ail wh ere yo u w ant th e invo ice t o b e sent : </p><p>Name Preferred on Badge:_ _ _ Do you need special assistance to participate in this meeting? Yes No I f s o, an E CCO r ep r e s e n tat i ve w ill c onta c t y ou. </p><p>Registration Fees</p><p>$450 Meeting Fee (until March 19, 2017) $500 Meeting Fee (after March 19, 2017)</p><p>Tax ID and Non-Profit Identification: Export Control Coordinators Organization. Tax ID# 82-0529967 – Texas Non-Profit ID#320487269421.</p><p>If you would rather send a check:</p><p>Mail your form and check to: Pacific Northwest National Laboratory Attn: Kimberly Galloway P.O. Box 999, MS: K8-50 Richland, Washington 99352 Your registration and payment are requested by March 20, 2017 You may also fax a copy of your registration form to (509) 375-2006, attention Kim. Please contact Kimberly Galloway by e-mail [email protected] or by phone at (509) 372- 6184 if there are any questions concerning the payment of registration fees. </p>