COMPANY / ORGANIZATION:(Required)Company / Organization Mailing Address:(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country #1: Participant Name:(Required) First Last #1: Participant Title:(Required)#1. Participant Email:(Required) #1. Participant Phone:(Required)TU NORTH CAMPUS TOUR | #1 | Tues. Sept 15 | 2:00 - 4:30 pm(Required) YES! I'll be there. Unfortunately, I am unable to attend. I am unsure, please contact me closer to the conference date. #2: Participant Name:(Required) First Last #2. Participant Title:#2. Participant Email:(Required) #2. Participant Phone:(Required)TU NORTH CAMPUS TOUR | #2) | Tues. Sept 15 | 2:00 - 4:30 pm(Required) YES! I'll be there. Unfortunately, I am unable to attend. I am unsure, please contact me closer to the conference date. #3: Participant Name:(Required) First Last #3. Participant Title:(Required)#3. Participant Email:(Required) #3. Participant Phone:(Required)TU NORTH CAMPUS TOUR | #3 | Tues. Sept 15 | 2:00 - 4:30 pm(Required) YES! I'll be there. Unfortunately, I am unable to attend. I am unsure, please contact me closer to the conference date. Additional Participants? List Information Here (name, title, email, phone, and if the plan to attend the NC Tour):REGISTRATION FEE (select one)(Required) $795/person | TEAM DISCOUNT | email cc payment instructions to each person individually TEAM DISCOUNT | email cc payment instructions to the person listed below to process payment (total amount) for the entire group - $795/person Send Payment Instructions to: First Last Title:Phone:Email: Registration Submittal & Payment Information:Complete the registration information, then click the SUBMIT button below. Once the registrations are received in our office, we will contact each via email with instructions on how to make a cc payment using the university's secure online payment portal. NOTE: payment is due immediately after receiving the email to lock-in this rate.Questions or Comments:Contact Us:ROSA ENERGY CONFERENCE The University of Tulsa, College of Engineering & Computer Science Continuing Education for Science & Engineering cese@utulsa.edu; www.cese.utulsa.edu; 800 S. Tucker Drive, Tulsa, OK 74104