Preregistration Form - 2000 SIAM Annual Meeting

SIAM is pleased to offer secure ordering. If you are uncomfortable sending credit card information over the Internet via a secure socket connection, please refer to How to Order SIAM Products for alternative payment methods.

To ensure that your registration is processed correctly, please consider the following:

• Fill-in the form accurately
• Indicate the events you will be attending to give SIAM an accurate count for meal and reception quarantees
• 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 will 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." If you do not see this pop-up message, please contact [email protected] for assistance.

A written confirmation will be mailed to you within 10-15 working days. If you do not receive it, please contact [email protected]. If the conference has already started, your receipt will be included in your registration packet on-site.

Select the Appropriate Registration Fee

Spouse/Guest Information

If more than 3 guests, please indicate names:

* Children 10 years old or younger do not have to pay guest registration fee. However, please indicate name and age of each child

Select the Get-Together Events You Will be Attending

The events below are complimentary unless a fee is indicated. Please indicate the events you will be attending to give SIAM an accurate count for meal and reception quarantees. Events are categorized by day so please review carefully. See registration information for the details on each event.

My total payment for the registration fee(s) I selected above including fees for spouse/guests, poster reception, and teachers' workshop parking pass is

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 American with Disabilities Act, or assistance in registering for this conference/meeting, please contact Coley Lyons by fax: (215) 386-7999 or e-mail: [email protected].
Name Badge Information:
I prefer my name and affiliation to read as follows:
Name (20 Characters):
Affiliation (20 characters):
Payment Information:
I wish to pay by:
Credit Card Number:
Expiration Date:

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