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HTCG Dialogue on Defense Technology, Data Privacy, and Export Licensing

A Public-Private Forum Under the Auspices of the
U.S. - India High Technology Cooperation Group

Registration Form

November 18, 2004
U.S. Department of Commerce
Main Lobby
14 th St. and Constitution Ave.
Washington , DC 20230

Instructions:
You may register on-line by filling out the form below and clicking on the "Submit" button.
You may also register by faxing a printout of the form below to Chris Shybut at (202) 463-3173 by November 12, 2004 .

Please address any questions to Chris via email cshybut@uschamber.com or phone (202) 463-5492.

Participant (PLEASE FILL OUT COMPLETELY)

Note: This Forum is now filled up. No new registrations are being accepted.

Name:
Title:
Company:
Address:
City:
State:
Zip:
Country:
Phone:
Fax:
Email:
Roundtable Session (SELECT ONE) Defense or Information Technology
Will you attend the Export Licensing Session? Yes No
Participant's Area of Expertise:
Experience in U.S.-India Trade and Investment:

If you are not a U.S. citizen or permanent resident, please provide the following information for security clearance purposes:
Nationality:
Passport Number:
Date of Birth:

BIS Privacy Notice

HTCG Dialogue on Defense Technology, Data Privacy, and Export Licensing

A Public-Private Forum Under the Auspices of the U.S. - India High Technology Cooperation Group

Registration Form

A Public-Private Forum Under the Auspices of the
U.S. - India High Technology Cooperation Group