ICSP3 - Conference Registration

Payment must be made by US dollar check payable to ISPA, or by Visa or Mastercharge. Sorry, foreign-currency checks, and POs cannot be accepted.

Send ICSP3 Registration Form to:

	ICSP3 Registration
	c/o Pegasus Systems
	125 Beechwood Road
	Summit NJ 07901


Please circle fees you are paying. The lower rate applies to registration received before September 23. Request for refunds of registration will be honored through September 30.

Advanced Registration Fee (before September 23):
	US $300		Students US $100

Late Registration Fee (after September 23):
        US $350         Students US $120

Conference registration includes copy of proceedings, coffee breaks, Monday night reception (except the students), and lunches Monday and Tuesday.

TOTAL amount enclosed: ___________________________________

Name (for name tag): _____________________________________

Affiliation (for name tag): ______________________________

Address: _________________________________________________

City: ____________________________________________________

State/Province: __________________________________________

Postal code/Zip code: ______________ Country: ____________

Tel: ______________________ Fax: _________________________

Email: ___________________________________________________

[  ] Check     [  ] VISA      [  ] Mastercharge

Credit Card Number: ______________________________________

Credit Card Expiration Date: _____________________________

Signature: _______________________________________________


This information last updated Tue Jun 7 16:03:21 EDT 1994