GD97 Preregistration Form

Registration Fees

Join SIAM today and save on your registration as a member!

A special 15-month membership application form is available for attendees of the Fifth SIAM Conference on Geometric Design. Both this registration form and the 15-month membership form must be completed and submitted to SIAM to take advantage of this special offer.

Preregistration Deadline: Monday, October 20, 1997

Short Course Nov. 2, 1997
*SIAG/GDSIAM MemberNon-Member Student
Preregistration (Prior to Oct. 20) $150 $150 $195 $75
Registration (After Oct. 20) $195$195$240$75
Conference Nov. 3-6, 1997
Preregistration (Prior to Oct. 20) $185 $190 $230$40
Registration (After Oct. 20)$225$230$270$40
Western BBQ/Country Music $39 $39 $39 $39
*SIAM Activity Group on Geometric Design

Option and Rate Selection

I fall into this category:
SIAG/GD Member
SIAM Member

Do you want to register for the SIAM Short Course on Wavelets in Computer Aided Geometric Design and Graphics Yes No

Do you want to register for the Old-Fashioned Southern BBQ/Country Music Show on Tuesday, November 4, 1997 at 6:30 PM for $39.00 Yes No

Check here if you are joining SIAM to take advantage of the member registration fee. Don't forget to choose the SIAM Member category above!

Based on the registration fees chart and the options I chose, my total registration fee (including short course) is dollars.

Name, Address, and Phone Information

Business Address:
City: State: Zip:
Telephone: E-mail:
Home Address:
City: State: Zip:

Please send all SIAM correspondence to the following address:
Home Address Business Address

Please update my SIAM records to reflect the above:
Yes No

Are you a disabled participant that requires appropriate accommodations?
Yes No

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 at (215) 382-9800 or write to her at Society for Industrial & Applied Mathematics, 3600 University City Science Center, Philadelphia, PA 19104-2688.

Name Badge Information:

NAME BADGE - I prefer my name and affliation to read as follows:
Name (20 characters): Affiliation (20 characters):

Payment Information:

I wish to pay by:

Credit Card Number: Expiration Date:

Please submit this information to SIAM.

To take advantage of preregistration rates, both Preregistration Form and payment must be received at the SIAM office by October 20, 1997.

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MMD, 10/28/97