ICGI '98 Electronic Registration Form


Early Registration Deadline:    May 11, 1998 for authors and May 21, 1998 for others.

Registration Fees:     The conference registration includes the conference proceedings and the banquet (on Monday, July 13, 1998).


Registrant Information

 First Name :  
  Last Name :  
  Telephone :  
        FAX :  
      email :  
Affiliation :  

Address

 Street Address 1 :  
 Street Address 2 :  
             City :  
            State :  
          Country :  
         Zip Code :  

Meals

A conference banquet is planned for Monday July 13, 1998.
The cost of the banquet is included in your conference registration. Additional banquet tickets may be purchased at $25 per ticket.

Number of additional banquet tickets desired 

Vegetarian
Not Vegetarian

 
Special Dietary Restrictions : 

Airport Shuttle

  1. I will make my own transportation arrangements.
  2. I would like to avail of the airport shuttle.

Shuttle Timings (You may take any of the following shuttles)

If you are planning to take the airport shuttle please provide us with the following information.

     Arrival Date and Time :  
 Airline and Flight Number :  
   Departure Date and Time :  
 Airline and Flight Number :  

Student certification

Not a full-time student

Full-time student


Special Requests

In order that we may better serve your needs please inform us of any special requirements or restrictions that you may have.

 Special Needs:  

Payment Information

  1. Check (payable in US dollars).
  2. Credit card:
    • Mastercard.
    • Visa.
    • Discover.
    • Card Number

Note:
This transaction is NOT SECURE. If you would like to pay by check or send the credit card information separately (by fax or postal mail) please send a copy of the payment information form along with the check (if applicable) to:

Janet Gardner
Extended and Continuing Education
102 Scheman
Iowa State University
Ames, IA 50011-1112
TEL: (800)-262-0015 (toll free number)
TEL: (515)-294-5366
FAX: (515)-294-6223
e-mail: x1jrgard@exnet.iastate.edu


Cancellation

If you cancel your registration on or before May 15, 1998, 80% of the registration fees will be refunded. For cancellations made after May 15, 1998, no refunds will be made. Accomodation arrangements should be handled directly with accomodation providers.

To cancel your registration please write to:

Janet Gardner
Extended and Continuing Education
102 Scheman
Iowa State University
Ames, IA 50011-1112
TEL: (800)-262-0015 (toll free number)
TEL: (515)-294-5366
FAX: (515)-294-6223
e-mail: x1jrgard@exnet.iastate.edu



Please report problems with this form to the Conference Chairs
Vasant Honavar and Giora Slutzki
Printable Registration Form
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