Note: This form is provided on WWW for your convenience. Return this form and your payment by regular mail. We do not recommend sending credit card information via the Internet.
Name: ___________________________ Affiliation: ___________________________ Address: _________________________________________________________________________________ ________________________________________________________________________________________ Telephone: ___________________________ Fax: ___________________________ e-mail: ___________________________
Method of Payment:
__ Check in U.S. dollars payable to "UMIACS-IWSED 95"
__ Visa
__ Mastercard
__ Discover
Credit Card Number: ___________________________
Credit Card Expiration Date: __________
Signature: _______________________________
Payment must accompany the registration form. Checks must be in US dollars only and payable to "IWSED 95." Please do not send cash.
The number of conference participants is limited as are hotel rooms. Please register as soon as possible to ensure participation and accommodation at the Inn and Conference Center.
Return by August 31, 1995 to:
Johanna Weinstein
UMIACS
University of Maryland
College Park, MD 20742, USA
Tel.: (301) 405-6722, Fax: (301) 314-9658
e-mail: johanna@umiacs.umd.edu