IEEE International Symposium on Bio-Informatics & Biomedical Engineering Arlington, VA November 8-10, 2000 Registration Form Each paper must be accompanied by one registration and payment to guranatee publication in the proceedings. Papers that will be received without registration and payment will not be published in the proceedings. If an author has more than one papers, each paper must be accompanied by a separate registration. For single-author papers, full registration is required only for the first paper while a lower registration ($250) is required for each additional paper. In the case of multiple-author papers, full registration is required for each paper. No more than three papers per symposium will be accepted from the same author. At least one author of each paper must register by the early registration deadline (August 25, 2000). ================================================================== Last Name (Dr./Prof./Mr./Mrs./Ms.) _________ First Name __________ Affiliation ______________________________________________________ IEEE Membership# _________________________________________________ Address __________________________________________________________ __________________________________________________________ __________________________________________________________ Country _____________________ Telephone __________________ Fax ________________ E-mail ______________________________ Registration fee (all in US Dollar) ----------------------------------- Delegate Type Early Registration Late/On-site Registration (by August 25, 1999) ------------------------------------------------------------------ Author (IEEE Member) $400 N/A Author (Non-IEEE Member) $475 N/A Delegate Type Early Registration Late/On-site Registration (by October 15, 1999) (after October 15, 200) ------------------------------------------------------------------ Non-Author (IEEE Member) $400 $460 Non-Author (Non-IEEE-Member) $475 $580 Students (non-authors) $200 $200 ITAB Members $320 $320 ITAB Members (no lunches, tour $125 $125 and dinner) Number of registrations: _____________ Total: _____________ Refund Policy ------------- All requests of refund (for non-authors only !!) must be made in writing 2 weeks prior to the date of the conference. However, a $50 processing fee and conference cost will be collected. Payment ------- Check or Money Order (payable to BIBE2000): amount enclosed ________ Credit Card (check one): Master Card ____ Visa _____ Discover _____ American Express _______ Cardholder's Name _________________________________________________ Card Number: _________________________ Expire Date ________________ Signature _____________________________ Date ______________________ Do you need help for hotel reservation? If yes, please fill out the Hotel Reservation Form and fax it to the hotel directly (or call them). Please mail your registration form with your payment to (note that to qualify for early registration, the registration form with payment must be received by August 25, 2000): Prof. Nik. Bourbakis 3916 Fuller Hollow Rd Vestal, NY 13850 tel: 607-771-4033 fax: 607-777-4464 email: nbourbakis@stny.rr.com ===================================================================