Name:
Affiliation:
Address:
E-mail:
Phone:
Dietary restrictions:
Kosher / Vegetarian / None
Affiliation, as it should appear on the badge:
Registration fees | until 10/19 | after 10/19 | |
---|---|---|---|
ACM, SIGACT, IEEE | |||
or EATCS member | 330 | 390 | |
Author | 330 | 390 | |
Student | 110 | 130 | |
Other | 420 | 480 |
Machtey Fund contribution:
Total registration:
Name:
Address:
Card Type:
Card Number:
Expiration Date:
Signature:
I agree to pay the above total amount according to card issuer agreement.