DSOM 2000 Workshop Registration


Workshop Fee

  IEEE or IFIP Member  Non-Member Student
Early registration
(before November 3, 2000)
250 USD 280 USD 125 USD
Late registration
(after November 3, 2000)
280 USD 310 USD 150 USD

In addition to admission to the technical program, the workshop fee includes :

DSOM 2000 will accept payment by major credit cards (Visa, MC, AMEX, Diners Club, Discover). Please complete the form below including information on the card type, account number and expiration date. Print out the form and send it to the DSOM 2000 Registration agent by facsimile or postal mail. If you fill in the form after having printed it out, please print clearly, especially your email address. A confirmation email will be sent to you when the registration is received. Please indicate any special needs (meals, access, etc.) on the form in the area provided. For hotel reservations, please go to the Accomodations section of this Web site.

Mail or Fax your registration form to:

	DSOM 2000 Registration
	Attn: Stella Stewart
	c/o Kinko's
	187 Dartmouth St.
	Boston, MA 02116  USA
	617-262-6265 fax
	617-262-6188 phone
On-site registration will also be possible.

Registration Form

Personal Information

Information with a (*) is required. Please do not use any special characters such as , etc.

                       Mr.    Ms.    Mrs.
Last Name   (*)         : 
First Name  (*)         : 
Title                   :  Prof.    Dr.    Other 
Affiliation/Company (*) : 
Postal Address          : 
City                    : 
State or Province       : 
Zip                     : 
Country                 : 
Phone  (*)              : 
Facsimile		: 
Email  (*)              : 
Member of               :  None   IEEE   IFIP  
Member no.              : 
Student                 :  No    Yes
(For students: Proof of status is required, and should accompany this form.)

Special Needs           : 

Extras(All items below will also be on sale on site.)
Number
Additional Tickets for Social Event: (cost per ticket = 30 USD)
Additional Copy of Proceedings: (cost per proceeding = 45 USD)

Payment

Credit Card Type (*)    : 
Account Number   (*)    : 
Expiration Date  (*)    : / Month/Year
Total amount     (*)    :  $  US

Signature               : _________________________________________

For questions on registration, please contact Ana Rabicoff ( DSOMreg@aol.com )
For questions on the technical program, please contact Gautam Kar ( gkar@us.ibm.com )


Modified September 27, 2000