REGISTRATION FORM ICNP 2001

Riverside, CA

November 11-14, 2001

 

A single-page version of this registration form is also available.

Name:                      ________________________________________________________

                                (First)                      (Middle)                                  (Last)

Affiliation:              ________________________________________________________

Address:                  ________________________________________________________

City:                        ______________________    State: ____________________

Zip Code:                ______________________    Country: _________________

Phone:                     ______________________    Fax: _____________________

Email:                      _________________________________________________

Are you a Member of IEEE/Computer Society? Yes #_____________

 

Conference Registration EDP# 012Q91:

Advance Registration (by October 10, 2001):                        Late/On-Site Registration:

IEEE Member         $500.00   __________                            IEEE Member         $600.00   __________

Non-Member          $625.00   __________                            Non-Member          $725.00   __________

Student                    $150.00   __________                            Student                    $175.00   __________

Extra Reception      $50.00     __________                            Extra Reception      $50.00     __________

Total Amount Due:              __________                            Total Amount Due:              __________

The registration fee includes admission to technical sessions, a copy of the proceedings, a reception at the Riverside Citrus State Park (November 12, 2001) (additional tickets for reception $50.00), lunch (November 13, 2001), and morning/afternoon breaks in on all three days.

 

Tutorials EDP#012Q92:

Advance Registration (by October 10, 2001):                        Late/On-Site Registration:     

IEEE Member         $250.00   __________                            IEEE Member         $300.00   __________

Non-Member          $320.00   __________                            Non-Member          $375.00   __________

Student                    $200.00   __________                            Student                    $250.00   __________

Total Amount Due:              __________                            Total Amount Due:              __________

The tutorial fee includes a copy of the tutorial notes, breakfast, lunch, and morning/afternoon breaks. There are two tracks: Track-1 (1 full-day tutorial), Track-2 (2 half-day tutorials).

I will be attending the _____ FULL-DAY Tutorial, or ______ the two HALF-DAY Tutorials (please check at most one).

 

Food Restrictions:      Vegetarian/Diet (   ) ____________

 

Method of Payment: Amount to be charged: _____________

(Sum of conference registration fee, additional reception tickets, and tutorial registration fee)

 

NOTE:  Payment can be made by Credit Card, Check or Money Order to the address listed below.  For credit card payments, a copy of this form, with information and signature may be faxed/mailed to the following information below.   Checks or money orders can be sent to the address listed below.

 

1.  Credit Card: # __________________________________________

                                    (Visa and Master Card Only)

     Expiration: ________

    

     Signature: (Required for Credit Card)______________________________

    

     Name: _______________________________________________

 

2.  Check or Money Order:        Payable to:      UC Regents                 (In USA Dollars)

 

Address for Mailing:             

Les J. Cromwell, Manager, Conference & Instructional Support Services

Attention:  ICNP Conference 2001

University of California, Riverside

1200 University Avenue

Riverside, CA 92507-4596

Email:                                      Lcromwell@ucx.ucr.edu

Fax:                                         (909) 787-7273

Telephone:                              (909) 787-4105 Ext. 1075  

 

Cancellation Policy:   Full refund, less $100.00 for administrative fees, before 10/10/01; no refund after this date.