Marketing Works Now

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The Customer Creation Coalition Program Registration
July 20th, 2005 from 8:30 a.m. to 1:00 p.m.
Holiday Inn Hotel and Conference Center
543 Route 9, Fishkill, NY 12524
Welcome.  Please enter your information below.  Fields marked with an * are required.

Name*	Mr. Mrs. Ms. Dr.
Company Name*		Title*
Key Code*
Key code is in lower right hand side of the inside of the invitation. Please use REG720 if you cannot find your keycode.
Address
City		County
State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia 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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip*	-
Country	U.S.A. Albania Algeria American Samoa Andorra Angola Anguilla Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Barbuda Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Botswana Brazil British Virgin isl. Brunei Bulgaria Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Rep. Chad Channel Islands Chile China Colombia Congo Cook Islands Costa Rica Croatia Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Irak Iran Ireland Ireland, Northern Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kuwait Kyrgyzstan Latvia Lebanon Liberia Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar/Burma Namibia Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Rwanda Saba Saipan Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Togo Trinidad-Tobago Tunisia Turkey Turkmenistan United Arab Emirates U.S. Virgin Islands U.S.A. Uganda United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wales Yemen Zaire Zambia Zimbabwe
Primary Phone*	-  -	Email*
Fax	-  -	Website URL
Cell Phone	-  -

Questions
1: Select the description that best describes your type of business:	Advertising/Design/PrintingGovernment: Local/State/FederalManufacturingNot-for-profitRetailServicesWholesaleOther
2: I will attend the July 20th program.	YesNo
3: I am unable to attend, please...	Invite me to the next program.Keep me on the mailing list.Take me off your mailing list.
4: Please invite a colleague to the program, their email address is:
5: Which statement best describes your firm's approach to marketing?	Allocates a marketing spend.Makes marketing investments.
6: Which of the following activities do you apply to your marketing programs?	Track marketing investment returns Manage marketing investment risk Find and exploit economic leverage All of the above None of the above
7: Does your firm accurately measure your Return On Investment for your marketing dollar spend?	YesNo

Disclosures
We will only disclose your personal information to suppliers we engage to process data on our behalf or successors in title to our business.  We will not disclose your personal information to any other person without your consent. Our web site may contain links to other web sites which are outside our control and are not covered by this Privacy Policy.  If you access other sites using the links provided, the operators of these sites may collect information from you which will be used by them in accordance with their privacy policy, which may differ from ours.