To     To register, complete and fax or mail this form with full payment to: Registration Chair Yu Wang at the information at the end of this form, as soon as possible but no later than August 31, 2001.  Capacity is limited and non-program participants are accepted according to the order of completed registration form with full payment received by the registration chair.
            
                                                             FTDCS 2001 Registration Form

Items

Amount

Workshop participant

 

IEEE Member* or IEEE-CS Affiliate* US $360.00
Non-member US $450.00

Overpage Charge of camera-ready paper in the workshop proceedings**

(______pages   US150/page)

 

US $________

Accompanying person(s)

(____persons @ US$200/person)

 

US $________

Names of accompanying person(s)

1.______________________________

2.______________________________

3.______________________________

Total Amount

US $_________

     
 
        * IEEE Member or IEEE-CS Member must include membership number in order to register at the reduced rate US$360.00
IEEE or IEEE-CS Affiliate Membership No._________________
 
      **  $150 per page beyond the 7th page
 
      Registration fee includes admission to all technical sessions, a copy of the proceedings, all social functions, excursion to Venice on November 1, coffee breaks, lunches, and admission to welcome reception.
.
     Accompanying Person registration fee includes admission to all social functions and excursion to Venice on November 1.
 
      Once registered, requests for cancellation will be accepted if requests are received by the registration chair no later than September 29, 2001 with the following exception:  If the registrant is an author of a paper published in the workshop proceedings, the request for cancellation of registration is accepted only if there will still have at least one of the co-authors of this paper registered and present the paper at the workshop.  For each registration canceled, a service charge of US$50.00 will be deducted from the refund of the cancelled registration fee.
 
Registrant Information

Name______________________________________________________

                                       Last/Family               First                 Middle Initial

Affiliation_______________________________________________

Internal Mailing Address___________________________________

Street Address____________________________________________

City__________________, State_________, Zip________________

Country________________________________________________

Phone_______________________, Fax_______________________

Email__________________________________________________

Payment Information 
Payment Type [please check one]

_________Check*

*Checks must be drawn from a US bank and in US Dollars only.

*Checks must be payable to IEEE Computer Society - FTDCS 2001.

Credit card: ______Master, ________Visa

Card Number:__________________________  Expiration Date_____________

Card-owner's Signature______________________________________________

Total Amount_______________________Date___________________________

 

FTDCS 2001 Registration Chair

Yu Wang
Arizona State University
Computer Science and Engineering Department
Goldwater Center, Room 206
Mailcode: 5406
Tempe, AZ 85287-5406 USA 

Telephone: 1-480-965-1746
Fax: 1-480-965-2751
Email: wangyu@asu.edu