REQUEST FOR ATTENDEE REGISTRATION

The MINE, LLC conferences are private-investor events designed to provide qualified investors access to companies and their executives. Registration is limited and by invitation only for institutional investors and analysts. To qualify, complete the form and fax the required documents mentioned below. All of the fields are required to submit the form. Please type "N/A" if the field is not applicable to your company. Your request will be reviewed and a response will be sent to you.

Please note that this is not a registration form! If you are a qualified investor, you will be sent a personalized registration form.

All of the fields in this form are required to be completed before submitting the form.

Your name: Your title: Company Name: Company Address: Telephone: Fax Number: Your e-mail address: Company's Web Address: Please give a brief description of your company, including: Type of Company: What is your company's interest in the industry? Please summarize a brief description of your job: Your request will be reviewed and a response will be sent to you. Thank you!