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Third International Workshop on Verification, Model Checking and Abstract Interpretation 2002 -- REGISTRATION FORM Please fill in the registration form and send it either by email (preferably) or by fax to: Agostino Cortesi Dipartimento di Informatica Universita' "Ca' Foscari" di Venezia Via Torino 155 30173 Venezia Mestre, Italy Email: cortesi@dsi.unive.it Fax: +39 041 2348419 Last name __________________________ First name __________________________ Affiliation _______________________________________________________________ Address ___________________________________________________________________ ___________________________________________________________________________ Zip code ____________________ City ______________________________________ Country ___________________________________________________________________ Tel ________________________________ Fax ________________________________ E-mail ____________________________________________________________________ I need extra banquet tickets (number) _____________________________________ Accompanying person(s) Last name __________________________ First name __________________________ REGISTRATION FEES quoted in Euro (EUR). Registration fee EUR 300.00 (_) Student (*) EUR 200.00 (_) Extra banquet ticket EUR 70.00 (_) Total payment to be made on site ___________ (*) Students must certify their status. Regular and Student's fees include participation to the scientific sessions, coffee breaks, two lunches, the proceedings booklet and the social dinner. PAYMENT All payments must be in Euro and should be made on-site. Please notice that only cash will be accepted.