You may register by filling the registration form below and submiting it via email,
regular mail or fax. An ASCII version of the form can be
found here.
| Ms. Kusum Shori Attn: NOSSDAV Registration Computer Science Department University of Southern California 941 W. 37th Place Los Angeles, CA 90089-0781 USA |
Email: kusum@usc.edu
Voice: +1 213-740-7286 FAX: +1 213 740-7512
|
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NOSSDAV 2002 REGISTRATION FORM
First Name: ___________________________________________________________
Last Name: ___________________________________________________________
Affliation: _____________________________________________________________
Email: ________________________________________________________________
Street Address: _________________________________________________________
City: ________________________________ State/Provence: ____________________
Zip/Postal Code: ______________________________ Country: __________________
Telephone: ________________________ FAX: _______________________________
ACM Member? Yes___ ACM #: ______________________________________ No___
Full-time Student? ___ Yes ___ No [Students must supply evidence of
student
status (e.g. student ID) at the conference]
DIETARY RESTRICTIONS: Vegetarian Other (specify): _________________________
PAYMENT INFORMATION:
| Registration Fees | On or Before May 10, 2003 | After May 10, 2003 |
| ACM Member | $400 | $450 |
| Non-ACM Member | $450 | $500 |
| Student | $300 | $350 |
Payment Method (check one): ___ Check ___ Money Order ___ Credit Card
Check or money order must be made in US dollars, payable to: ACM NOSSDAV
2003.
For credit card transactions
please fill out the information below:
Credit Card (check one): ___ Visa ___ MasterCard ___ American Express
Credit card number:_____________________________________________________
Expiration Date:________________________________________________________
Name on the credit card:________________________________________________
Total Charges Authorized (see chart above):__________________________________
Signature: ____________________________________________________________
Please note that any credit card information you fax or sent via
physical mail will be entered on-line into a secure payment server
for processing. Signing above also indicates your approval of this
transmission.
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For further information please contact the program chairs: