There are only two ways to submit this registration form: by email or fax. BY EMAIL: Send the registration form to: Priscilla Coe (coe@cs.umass .edu) http://www.cs.umass.edu/~coe/ BY FAX: Send the registration form to: Priscilla Coe +1 413 545 1249 NOTE: You will receive an email confirmation within a few days of submitting your registration form. ------------------------------------------------------------------------ Full Name (Given Name then Family Name)_________________________________ Name as it should Appear on Badge ______________________________________ Affiliation (as it should appear on badge) _____________________________ Address ________________________________________________________________ City ___________________________ State/Province _______________________ Zip/Postal Code ________________________________________________________ Country ________________________________________________________________ Email __________________________________________________________________ Phone (optional) _______________________________________________________ Food Preference (Regular/Vegetarian) ___________________________________ REGISTRATION FEES (Circle reg. rate and tutorial rate(if attending). All fees are in US Dollars: BEFORE Oct 10th AFTER Oct 10th Registration: Normal rate $310.00 $385.00 Registration: Student rate $180.00 $250.00 Tutorials: Normal rate $130.00 $180.00 Tutorials: Student rate $75.00 $125.00 Note: Each group of paper authors is required to have one normal registration rate. Also not that hotel rate cut offs are different (earlier) dates. PAYMENT -- NGC 2002 payment is BY CREDIT CARD ONLY Type (Visa/Mastercard ONLY)___________________________________________ Number _________________________________________________________________ Card Expiration Date ___________________________________________________ Name on Card (Exactly how it appears) __________________________________ Total amount to charge to card _________________________________________ Signature ______________________________________________________________ Date ___________________________________________________________________ WRITTEN REQUESTS FOR REFUNDS MUST BE RECEIVED NO LATER THAN OCTOBER 20, 2002. REFUND REQUESTS RECEIVED AFTER THIS DATE WILL NOT BE ACCEPTED. REFUNDS ARE SUBJECT TO A $50 PROCESSING FEE.