Registration Form

 

Please e-mail to Narode@ecse.rpi.edu

 

Last NAME:   

FIRST NAME:            INITIAL:

Y:

ORGANIZATION:

ADDRESS line_1:

Line_2:

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TELEPHONE:             FAX:

E_MAIL:

 

CHECK ONE OF THE FOLLOWING OPTIONS:

1.      I AM INTERESTED IN ORAL PRESENTATION

2.      I AM INTERESTED IN POSTER PRESENTATION

3.      I WILL NOT PRESENT A PAPER

4.      PROPOSED PAPER TITLE IF OPTION 1 or 2 are selected

 

Registration fee (includes conference attendance, proceedings, banquet, coffee breaks, and a memory stick with the conference abstracts).

Before or on September 1st, 2007

$400 for regular attendees $350 for IEEE members $200 for students

After September 1, 2007 but before November 1st

$450 for regular attendees $400 for IEEE members $250 for students

After November 1st or on-site

$500 for regular attendees $450 for IEEE members $275 for students

 

PAYMENT OPTIONS:

 

1. By check payable to Rensselaer Polytechnic Institute and mailed to

 

Mr. George Narode

RPI, ECSE Department

6003 Jonsson Engineering Center          

Rensselaer Polytechnic Institute          

110 8th Street, Troy, NY 12180-3590                          

PH: (518) 276-6071

FAX:(518) 276-6261

narodg@rpi.edu

 

2. By credit card (VISA or MASTER CARD only) by filling and mailing or faxing or scanning and emailing the following  form to Mr. George Narode

 

NAME on the card

 

CARD NUMBER

 

EXPIRATION DATE

 

SECURITY CODE

Signature