Preregistration deadline: Wednesday, March 20, 2002
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
A written confirmation will be mailed to you within
10-15 working days. If you do not receive it, please contact email@example.com.
If the conference has already started, your 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." If you do not see this
pop-up message, please contact firstname.lastname@example.org
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 preregistration rates, both Preregistration Form and payment must be received at the SIAM office by Wednesday, March 20, 2002.
Please select only one of the registration fees below
Preregistration Deadline: Wednesday, March 20, 2002
Conference Banquet Dinner
On Thursday, April 11, 2002, 7:00 pm - 10:00 pm, there will be a Conference Banquet Dinner.
The cost is $60 per person. The dinner menu will include:
Chilled Italian Tomato Soup with Basil
Mustard Seed Crusted Mahi-Mahi
Chefs Choice vegtables and potatoes
Assorted Rolls and Butter
White Wine with Dinner
White Chocolate Mousse Torte with Blueberry Coulis & Shaved Chocolate Flakes
To confirm, please type in the total dollar amount of your registration. My total registration fee is
Please submit this information to SIAM