PKAW 2000 Registration Form


Last name:
First name:
Affiliation:
Mailing address:
EMail address:
Fax:
Phone:
Vegetarian [ ] Other dietary restrictions [ ] Please specify


Registration fee A$ 400 or A$ 200 for students - please circle as appropriate
Extra Harbour Cruise Banquet Ticket(s) A$ 125 each - please indicate how many your require

Total A$

Your registration will be confirmed upon receipt of payment. Payments can be made either by credit card or by a Australian Dollar cheque drawn in favour of University of New South Wales. Indicate your payment method:
Cheque [ ] Visa [ ] Master Card [ ]

If paying by card, please fill in the following details:

Card Number:
Name on Card:
Signature:
Expiry Date:

Please send this form with your draft or the completed credit card information to the following address:

Ann Baker, School of Computer Science and Engineering, UNSW Sydney, NSW 2052, Australia

If paying by credit card, this form with the completed credit card information can also be faxed to the secure number: +61-2-9385-4071. Receipt of payment will be confirmed.
If you are an author, please make sure that at least one author's registration for each paper is received by 24 November 2000.
 


Last modified: Tuesday 7 November 2000