| 1999 WECSdsap Registration Form |
|__|__|__|__|__|__|__|__|__|__|__|__|__|__| |__|
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
First Name
MI Last Name
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Institution
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Address
|__|__|__|__|__|__|__|__|__|__|__|__|__| |__|__| |__|__|__|__|__|__|__|__|__|__|__|__|__|
City
State Postal Code
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Country
Email Network/Address
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
Phone
FAX
Registration to the 1999 WECSdsap Workshop includes attendance at the
technical sessions, coffee breaks, lunches, the Welcome Reception and the Banquet.
Registration fees are as follows:
| Prior to December 8, 1998: $365.00 On-Site: $405.00 |
Please Check off One: Shuttle Reservations from John Wayne Airport: $10 Shuttle Reservations from Los Angeles Int'l Airport: $20 q 3:00 pm - John Wayne q 2:00 pm - LAX q 4:00 pm - John Wayne q 4:00 pm - LAX q 5:00 pm - John Wayne q 6:00 pm - LAX q 6:00 pm - John Wayne |
| q Check q Electronic Money Transfer TOTAL: $________________________ |
Please Make Checks payable to WECSdsap.
Registration is not complete until payment is received.
Electronic Money Transfer:
Bank account number: 04436-09230. Routing number: 121000358
Bank account name: California Institute of Technology Commercial Account
Bank address: Bank of America. · L.A.Main ·
525 S. Flower Street · Los Angeles, CA 90071
Refund policy for Pre-registration: Registration cancellation and requests for refunds
must be in writing and received no later than December 18, 1998. There will be a $25.00
processing charge. No refunds will be issued after December 18, 1998.
| Return this form to: Janie Docter · Box 951594, · 420 Westwood Plaza, · Los Angeles, CA 90095-1594 · FAX (310) 206-4685 · |
Click here for the ASCII version of this form (email ready).