ICGI '98 Printable Registration Form


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

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


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ICGI'98 (July 12-14, 1998) Conference Registration Form

Registrant Information

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

Address

Street Address : ______________________________
                 ______________________________
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 
Dietary Restrictions : ____________________________
                       ____________________________
                       ____________________________
                       ____________________________

Airport Shuttle

 
___ I will avail of the shuttle
___ I will not avail of the shuttle
Arrival
  • Friday, July 10, 1998 8:00 pm
  • Saturday, July 11, 1998 2:00 pm
  • Saturday, July 11, 1998 8:00 pm
  • Saturday, July 11, 1998 11:30 pm

    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

    _____ Full-time student

     Institution      : ____________________________ 
     Advisor          : ____________________________ 
     Advisor's e-mail : ____________________________ 

    ____ Not a full-time student


    Payment Information

     Check       : Amount = US $ ___________ 
     Credit Card : 
             Mastercard ________________________ 
             Visa       ________________________ 
             Discover   ________________________ 


    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: ___________________________________
                    ___________________________________
    	        ___________________________________ 


    Please print this registration form and mail / fax along with a check or necessary payment information 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

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    Cancellation

    If you cancel your registration on or before May 15, 1998, 80% of the registration fees will be refunded. For cancellations 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


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