Army High Performance Computing Research Center (AHPCRC)
and University of Illinois, Chicago
is pleased to offer secure ordering. If you are uncomfortable sending
credit card information over the Internet via a secure socket connection,
please print this order form, fill it out, and fax it to SIAM at (215)
386-7999. If paying by check, please make your check payable to SIAM
and mail it with this filled-in form to SIAM, 3600 University City
Science Center, Philadelphia, PA 19104-2688. For more information
on alternative payment methods, please refer to How
to Order SIAM Products.
E-MAIL CONFIRMATION WILL BE SENT TO YOU WITHIN 10-15 WORKING DAYS.
If you do not receive it, SIAM has not processed your registration.
Please contact email@example.com
if you do not receive an e-mail confirmation by April 23, 2003.
Your printed receipt will be included in your registration packet
ensure that your registration is processed correctly, please fill
in the following form as accurately as possible. Make sure you include
your credit card number and expiration date. Registrations received
without payment will not be processed. Remember
to push the submit button when you're finished! A pop-up message should
appear saying "Thank you for filling in the form. Your response
has been received by our server. Thank you for using the SIAM Web
Server." This is not your registration confirmation.
If you do not see this pop-up message, please contact firstname.lastname@example.org
advance registration payments are to be made by credit card, check,
or money order. All fees quoted are in U.S. dollars. To take advantage
of preregistration rates, both Preregistration Form and payment must
be received at the SIAM office by Wednesday, April 2, 2003.
(For Statistical Purposes only)
In order to qualify for the Student Rate, students must list the
name, affiliation, and e-mail address of one professor who can verify
your student status.
I am a
**Student registrants will receive a Student badge
(Select all that apply, Conference Attendees
I wish to have a complimentary copy of the notes for:
(Check ONE only; additional copies available
for purchase on-site)
Conference Registration Fee Includes:
It is SIAM policy that all speakers pre-register. Speakers
who do not pre-register will be required to register on-site at the
SIAM wishes to take steps to ensure that no individual with
a disability is excluded, denied services, segregated or otherwise
treated differently than other individuals because of the absence
of auxiliary aids and services. If you need any auxiliary aids
or services identified in the Americans with Disabilities Act,
or assistance in registering for this conference/meeting, please
contact Coley Lyons by phone: (215) 392-9800; fax: (215) 386-7999
or mail: Society for Industrial & Applied Mathematics,
3600 University City Science Center, Philadelphia, PA 19104-2688.
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