CHI 97: Advance Program
chi97-help@acm.org
CHI 97 <- CHI 97: Advance Program
 ->
CHI 97 Advance Registration Form

CHI 97 Advance Registration Form

 Use this form if you cannot or do not wish to use the online registration form. Print this form out, fill it in, and mail or fax it to the address given at the end.

Conference and Tutorial Fees in U. S. Dollars
On or Before 26 February 1997 21 February to 13 March 1997 Onsite and After 13 March 1997
StudentMemberOther StudentMemberOther StudentMemberOther
Conference Fee Only $125 $395 $512* $135 $595 $712* $145 $795 $912*
Each Tutorial Unit with Conference Fee 110 255 255 120 355 355 140 455 455
Each Tutorial Unit without Conference Fee 185 315 315 195 415 415 215 515 515
Save paper, ink and phone time! FAX only the following two-page portion, please!

CHI 97 Registration Form
First (given) Name: Last (family) Name:
Full name you would like on your badge:
Company/Institution: Address1:
Address 2:City, State/Province:
Country : Postal Code :
Tel : Fax :
E-mail :

Check boxes for more information or requests:
O This is my first time attending CHI O Send info on childcare
O Special Needs and Access: (specify) - - - > > >  
O I do NOT want my name on a mailing list given or sold to outside organizations.
O I am a member of *: Member number:
* The list of eligible societies is found at http://www.acm.org/sigchi/chi97/ap/registration.html#U4
O I do NOT want ACM/SIGCHI membership included in the non-member conference fee.
(The fee does not change.)
O I am a full-time student providing proof of current student status with registration.

Conference Registration: O Yes O No

Tutorial Selections

  Units Please circle tutorial numbers
Saturday Evening1
   1  2
Sunday Full-day2
   3  4  5  6  7  8  9 10 11 12 13
Sunday Morning1
  14
Sunday Afternoon1
  15
Monday Full-day2
  16 17 18 19 20 21 22 23 24 25 26
Monday Morning1
  27 28 29
Monday Afternoon1
  30 31 32
Total Units   Add tutorial units above; the maximum number of units is 5.
Alternative Tutorials: > > > >
Saturday: Sunday:Monday:

Workshops (accepted registrants only)
  Price Please circle workshop numbers.
Saturday and Sunday$100
   Basic Research Symposium = Workshop  1
Sunday and Monday$100
   2  3  4  5  6  7  8  9 10 11
Sunday only $50
  12 13 14
Monday only $50
  15 16

Payment Computation

 
Conference Fee                                               $ ________
Tutorial Units                               ____ x $ ____   $ ________
CEU fee if desired*:           Tutorial Units ____ x $ 5     $ ________
Workshop Fee (accepted registrants only)                     $ ________
Accompanying Person (includes Reception)          @ $ 95     $ ________
Accompanying Person's Name:______________________
Extra Reception Tickets                      ____ x $ 50     $ ________
Extra Proceedings:                           ____ x $ 50     $ ________
Extra Abstract Volume:                       ____ x $ 25     $ ________
Extra NTSC Video:                            ____ x $ 20     $ ________
Extra PAL Video:                             ____ x $ 20     $ ________
Mugs:                                        ____ x $  5     $ ________
T-shirts:#                      M   L  XL    ____ x $  8     $ ________
Sweatshirts:#                   M   L  XL    ____ x $ 18     $ ________
Free video with registration:*  NTSC or PAL                  $     0.00

Total Fees Enclosed :                               $ _______
* For CEU credits, provide your social security number or other personal ID number below:
# Please circle shirt size and video format. Prices include applicable sales tax.

Send This form

 Forms without payment will not be processed. Make checks and money orders payable in U.S. Dollars to ACM/CHI 97. Purchase orders, government vouchers, and wire transfers are not accepted and will be returned to sender. If paying by VISA, MasterCard or American Express, please provide the following credit card information in full to avoid delays:

Credit Card Number: Expiration Date:
Cardholder's Name: Cardholder's Signature:
Billing Address (if different from above):

Mail Form to:
CHI 97 Registration Office
P. O. Box 941126
Maitland, FL 32794 USA 		For Express Mail only:
CHI 97 Registration Office
2060 Goldwater Court
Maitland, FL 32751 USA
Tel: +1 407 628 3602 Fax: +1 407 628 3186
CHI 97: Advance Program
chi97-help@acm.org
CHI 97 <- CHI 97: Advance Program
 ->