AD2004 Conference Registration

Deadline for preregistration: July 2, 2004
Deadline for late registration: July 16, 2004

Name and affiliation to appear on name badge: 

First Name:    Middle Initial:   Family Name:  

Organization or Affiliation:  

Conference events


Registration. Please select exactly one. I will attend:
Additional information. Please check all that apply.
Please note that no payment is required at registration. All payments will be collected at the conference; acceptable forms of payment are cash or institution check payable to The University of Chicago (in US dollars). The phone number of the Computation Institute is +1 773 834 6812. Checks can be mailed to:
    Computation Institute
    Research Institutes Building, 405
    Attn: AD2004
    5640 S. Ellis Avenue
    Chicago, IL 60637
    U.S.A.
Registration for the short course includes coffee breaks and lunch. Registration for the conference includes coffee breaks.

Fee schedule if registered by July 2, 2004 (all amounts are in USD).

Regular
 Student
Short course only
 $75
$75
Conference only
 $350
 $175
Short course and conference
 $400
 $225

Fee schedule if registered after July 2, 2004 (all amounts are in USD).

Regular
 Student
Short course only
 $125
$75
Conference only
 $450
 $275
Short course and conference
 $500
 $325

Contact information

Organization Address:

City:       State:       Postal Code:       Country:  

Organization Telephone:  

FAX Number:  

Email:  

Arrival:   Departure:  

I have the following special needs:  

Questions? Email ad2004@mcs.anl.gov.
Last updated: June 15, 2004