The 8th Annual Gilder / Forbes Telecosm Conference
October 19 - October 20
The Resort at Squaw Creek, Lake Tahoe, California


Hosted by:
George Gilder & Steve Forbes

Featuring:

John Mauldin

Please print, complete and submit the following via mail or fax.

fax: (413)644-2122

Gilder Publishing, LLC
291A Main St.
Great Barrington, MA 01230
ONE-TIME SPECIAL OFFER for John Mauldin's Thoughts From the Frontline subscribers, just $495 for an all-access Telecosm 2004 conference pass, including all technology and investing sessions, keynotes, and meals. Plus, register a guest for FREE! That's right, two can attend for just $495. PLEASE NOTE: THIS OFFER EXPIRES OCTOBER 15, 2004.

1. Your contact information
Full Name _________________________________________________
Title _________________________________________________
Company _________________________________________________
Street _________________________________________________
City, State, Zip _________________________________________________
Country

_________________________________________________
Email _________________________________________________
Phone _________________________________________________
Fax _________________________________________________
Your guest's
contact info:		 _________________________________________________
Full Name

_________________________________________________

Title _________________________________________________
Company _________________________________________________
Street _________________________________________________
City, State, Zip _________________________________________________
Country _________________________________________________
Email _________________________________________________
Phone

_________________________________________________

2. Supply Method of Payment (Payments will only be processed on approved applications).

(please check) I am a subscriber and understand that I am committing to attending this conference with my payment of $495.00.
PLEASE NOTE: THIS OFFER EXPIRES OCTOBER 15, 2004.
(If registering a guest, payments may be broken up between two cards.)
Credit Card 1
Amex    Visa     Mastercard ----Diners
Card Number: _________________________________________________
Expiration Date: _________________________________________________
Amount: __________ Name on card: _______________________
   
Credit Card 2 Amex    Visa     Mastercard ----Diners
Card Number: _________________________________________________
Expiration Date: _________________________________________________
Amount: __________ Name on card: _______________________


Cancellation Policy
Cancellations received in writing (a faxed letter is acceptable) by September 17, 2004, will be honored with a full refund of the conference registration fee. Cancellations after September 17, 2004 will not be honored with a refund. A substitute from the same organization may take the place of a registered attendee, or the conference registration fee may be applied to another conference hosted by Gilder Publishing within one year of the date of the conference to which registrant was originally registered.

Yes, I have read and understand the Gilder Publishing, LLC conference cancellation policy. (please check)