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Registration Form
* Denotes A Required Field
Personal Information:
First Name: *    Last Name: *
Badge Title:    Badge Name:
Affiliation:
Mailing Address Line 1: *
Mailing Address Line 2:
City: *   State: *   Zip/Postal Code: * -
Country: *
Phone: *    Ext:
Fax:
E-mail Address: *
Registration confirmation and program information will be sent to this address.
Paper Number: (if applicable)
Societies for discounted registrations:
IEEEAAAICognitive Science Society
Membership Number:
Required to show valid member ID card at the time of picking registration package.
Registration Categories:
Advance registration (by May 5, 2002).
Late/on_site registration (after May 5, 2002).
Every student registration is required to show valid (non-expired) student ID card at the time of picking registration package
* (Select One) Advanced Registration Late/On-Site Registration
Member $370 $445
Nonmember $460 $555
Student Member $150 $180
Full-time Student $180 $210
Additional Items:
Item Qty
Extra banquet tickets ($60/per person)
Extra Proceedings: Hard copy and CD ($80)
Extra Proceedings: CD Only ($25)
Payment Information:
* Select a payment type: (Instructions will be on next page)
     Check or Money Order
     Credit Card (AMEX, Visa, MasterCard)
Notes:
  1. All the registrations include tutorials and proceedings with CD.
  2. Student registration does not include the banquet.
  3. To be eligible for society registration, you need to show your non-expired membership card at the time you pick up registration package.
  4. Print, fill in and send the generated registration form with payment to
        Ms. Shelly Villareal
    3115 Engineering Building
    Michigan State University
    East Lansing, MI 48824
    FAX: 517-432-1061
  5. Registrations with credit card payment can be sent via FAX.
  6. Other types of payment need to be mailed in. The mail arrival date is considered as the registration date.
  7. Payment in check or money order must be in US dollars drawn from a US bank or one of its international branches. Make it payable to "Michigan State University, ICDL 2002".
  8. For bank to bank direct wire payment, send an email to Ms. Shelly Villarreal (shellyv@cse.msu.edu) for instructions.
  9. Refund policy: All refund requests must be in writing and received before May 25, 2002. No refunds will be accepted after this date. A $50 cancellation fee will be deduced from the registration fee.
 
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