NOSSDAV 2003 Registration Form

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



Voice: +1 213-740-7286

FAX: +1 213 740-7512




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): _________________________



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


For further information please contact the program chairs:

Christos Papadopoulos and Kevin Almeroth