PMCCS-4 Registration

PMCCS-4 Registration Form

	Registration fee:	$ 185
	______ additional banquet tickets at $65 each =	$ _______________
	Total:	$ _______________

Registration Information

	Last name:	________________________________________________________________
	First name:	________________________________________________________________
	Middle initial:	________________________________________________________________
	Affiliation:	________________________________________________________________

	Address (line 1):	________________________________________________________________
	Address (line 2):	________________________________________________________________
	Address (line 3):	________________________________________________________________
	City:	________________________________________________________________
	State:	________________________________________________________________
	Postal code:	________________________________________________________________
	Country:	________________________________________________________________

	Phone:	________________________________________________________________
	Fax:	________________________________________________________________
	Email:	________________________________________________________________

	Special needs:	________________________________________________________________
	(meals, access, etc.)	________________________________________________________________

Instructions

The workshop registration is due August 4, 1998.

Print this form, fill in the information requested, and mail the completed form and your check, made payable to "PMCCS-4", to:

Sonya Askew / PMCCS-4 Registration
College of William and Mary
Department of Computer Science
P.O. Box 8795
Williamsburg, VA, 23187-8795, USA

Phone: +1 757 221 3455 Fax: +1 757 221 1717
Email: pmccs4@cs.wm.edu

Submit a separate form for each individual.
Program registration includes two lunches, banquet, reception, coffe breaks, and copy of the talk presentations.
Payments must be by check in US funds and drawn on a US bank, or by certified check or bank draft, drawn in US dollars. Checks must be made payable to: PMCCS-4
Receipt of registration forms will be acknowledged by email.
Please note that the deadline to reserve a room at workshop rates is also August 4, 1998.