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AVoCS'03 Registration Form

AVoCS'03 REGISTRATION FORM

Print out, fill in, and post or fax it directly to the registration manager:

Simon Farrenden [Attn. AVoCS'03]
Dept. of Electr. & Comp. Sc.
Highfield Campus
University of Southampton
GB - SO17 1BJ
Fax: +44.2380.594489

Last Name:

First Name:

Title:

Affiliation:

Address:

Phone:

Fax:

eMail:

Privacy declaration:

My name, affiliation, and eMail address shall appear on the list of delegates [ ]
My name, affiliation, and eMail address shall NOT appear on the list of delegates [ ]

Prospective authors and speakers only:

If accepted, I would wish to publish my work only in the Pre-Proceedings [ ]
If accepted, I would wish to publish also in the selected Post-Proceedings [ ]

Registration type:

Ł 85.- Professional [ ]
Ł 60.- Student, with conference dinner [ ]
Ł 40.- Student, without conference dinner [ ]
Students only - Name and Signature of Professor:

Payment type:

I will send a cheque or bankers draft made payable to the University of Southampton [ ]
I wish to pay by VISA credit card [ ]
I wish to pay by MASTER credit card [ ]
I wish to pay by SWITCH debit card [ ]
card payers only - Name, Number, and Expiration Date on card:
card payers only - Amount (again), and Signature:

I understand that my registration agreement is binding and that my fees may not be refunded in case of myself not attending the workshop for whatever reason. I understand that all fees include value added tax (VAT) at the current rate. I understand that my registration includes a copy of the Pre-Proceedings, coffee break refreshments, and lunch, but no accomodation. I understand that I am responsible for making my own accomodation arrangements. I understand that I am not entitled for the conference dinner if I have chosen the registration option ``student, without conference dinner''. I understand that the conference organisers reserve the right to future re-arrangements as far as the publication of the announced Post-Proceedings are concerned.

Confirmation of registration - place, date, signature: