
Registration information
Conference registration:
You may either make a hard copy of this form and fax it to Ms. Cecilia Kullman (301-314-9658) or email her the requested information. You can also send a hard copy to
NAME: _____________________________
Affiliation: ___________________________
Address: _____________________________
____________________________________
____________________________________
Fax: ______________ email: _____________ telephone: ______________
Registration fee: $350 (before February 22); $425 (after February 22); Student ($75)
Amount enclosed: $________
Conference fees include:
Student registration includes breaks and proceedings only
Payment by:
Check - make payable to "UMIACS - AVBPA '99"
Credit card: _____Visa _______ MC _______Discover:
Card number: _________________ _______
Expiration ____________ Full name on card: _____________________
Disclaimer: Registration by mail or fax is strongly preferred for security reasons. UMIACS is not responsible for lost or stolen credit card information and cannot guarantee the safety of Internet transactions. You may register via email and then immediately submit credit card information by mail, fax or telephone. Registration is not guaranteed until payment is received.
| These pages are maintained by Larry
Davis Last update: May 20, 1997 |