Pre-registration Form (Mandatory Fields = *)

Grand Hyatt Seattle
721 Pine Street
Seattle, Washington 98101
Telephone: 1-206-774-1234
Reservations: 1-888-591-1234 (US and Canada)
Reservation Fax: 1-206-774-6033
http://grandseattle.hyatt.com/property/index.jhtml

Pre-registration deadline: October 13, 2003

SIAM 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.

AN 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 meetings@siam.org if you do not receive an e-mail confirmation by October 27, 2003. Your printed receipt will be included in your registration packet on-site.

To 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 meetings@siam.org for assistance.

All 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 pre-registration rates, an $80.00 savings, both Pre-registration Form and payment must be received at the SIAM office by Monday, October 13, 2003.

Personal Information

*Name:

*Male or Female:
(For Statistical Purposes only)

*Speaker Information:
*Organization Name:
*Organization Type:
Department:
*Address:
*City:
State:
*Zip:
*Country:
*E-mail:
Telephone:
Fax:

Student Verification

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
Professor Name:
Affiliation:
Professor E-mail:

Please select only one of the registration fees below

Pre-registration Deadline: Monday, October 13, 2003.

All advance registration payments are to be made by credit card, check, or money order. All fees quoted are in U.S. dollars.

Minisymposium organizers and speakers will also be required to register at the SIAM ON-SITE member rate if they do not preregister.

GD03 Registration - November 10-13, 2003

GD03 Short Course Registration

Short Course Registration Fees
SIAM Member
Non-Member
Student
Pre-registration - One Course
(on or before 10/13/03)
$135
$180
$50
Pre-registration - Both Courses
(on or before 10/13/03)
$225
$270
$70

On-Site Registration (After 10/13/03) - One Course

$180
$225
$50

On-Site Registration (After 10/13/03) - Both Courses

$270
$315
$70

If you are attending the Short Courses, please choose from the following selections:

One Short Course
Both Short Courses
SIAM Member - $135 for one, $225 for both
Non-Member - $180 for one, $270 for both
*Student - $50 for one, $70 for both

9:00 AM, SC1: Approximate Algebraic Methods
2:00 PM, SC2: Meshfree Modeling with Distances and Splines
Both SC1 and SC2

Boxed lunch preference: (CHOOSE ONE) *

Select GD03 Conference registration fee:

*

**SIAM Activity Group on Geometric Design

Please select the events that you plan to attend
Welcome Reception - Sunday, November 9 *

Conference Banquet, 7:00PM *
Wednesday, November 12

Princess Ballroom
Catered by 727 Pine

An eclectic northwest cuisine restaurant where you will experience a truly memorable taste of Seattle.
Join your colleagues at this popular networking event!

**TICKETED EVENT** $50.00 PER TICKET

*
# of Continental meals
# of Vegetarian meals

Conference Registration Fee Includes:

  • Welcome Reception, Sunday, November 9
  • Business Meeting, Tuesday, November 11
  • Coffee breaks daily
  • Admission to all technical sessions
  • Room set-ups and audio-visual equipment

It is SIAM policy that all speakers pre-register. Speakers who do not pre-register will be required to register on-site at the higher rate.

To confirm, please type in the TOTAL dollar amount of the registration rate(s) you selected.
My registration fee is $ dollars.
*

Send all SIAM Correspondence to: Home Business
Update my SIAM records to reflect the above: Yes No
Are you disabled and require appropriate accommodations? Yes No

Handicap Symbol 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 e-mail: lyons@siam.org; or mail: Society for Industrial & Applied Mathematics, 3600 University City Science Center, Philadelphia, PA 19104-2688.

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:

American Express Visa Master Card * 
Name as it appears on Credit Card: *
Credit Card Number: *

Expiration Date:

*

Please submit this information to SIAM

 

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