| < Payment in US Dollars > |
Early Registration Deadline April 25, 2003
Late Registration Deadline May 16, 2003 |
|
|
|
2003 VLSI Symposia
REGISTRATION FORM
| Remittance for the 2003 Symposium is strongly encouraged to be paid in Japanese Yen, by the use of internationally recognized credit cards, and through the Japanese Secretariat. |
| However, for special cases where payment in US dollars is more convenient or required, please remit payment through the US Secretariat. Please contact the US Secretariat concerning any unusual circumstances or methods of payments. |
| Please complete and return this form to |
|
Secretariat for VLSI Symposia (USA)
c/o Widerkehr and Associates
16220 S. Frederick Ave., Suite 312
Gaithersburg, MD 20877, USA
Tel: +1-301-527-0900 ext. 103 / Fax: +1-301-527-0994 / E-mail: vlsi@vlsisymposium.org |
| Please type or print in block letters to avoid trouble.
[ ] Prof.
[ ] Dr.
[ ] Mr.
[ ] Ms. /
[ ] Speaker
[ ] Committee |
Name: |
 |
, |
 |
|
 |
|
Family |
|
First |
|
Middle |
|
| Mailing Address:
[ ] Office
[ ] Home: |
 |
|
Country |
Tel: |
+
|
Fax: |
+
|
|
Country Code |
|
Country Code |
E-mail: |
|
Conference |
on or before
April 25 |
On or before May 16
and on-site |
Student*
On or before May 16
and on-site |
| VLSI Technology Short Course |
[ ] US$ 135 |
[ ] US$ 180 |
[ ] US$ 45 |
| Symposium on VLSI Technology |
[ ] US$ 455 |
[ ] US$ 500 |
[ ] US$ 180 * |
| Symposia on VLSI Technology and Circuits |
[ ] US$ 865 |
[ ] US$ 955 |
[ ] US$ 275 * |
| VLSI Circuits Short Course |
[ ] US$ 180 |
[ ] US$ 230 |
[ ] US$ 45 |
| Symposium on VLSI Circuits |
[ ] US$ 455 |
[ ] US$ 500 |
[ ] US$ 180 * |
| Silicon Nanoelectronics Workshop |
[ ] US$ 180 |
[ ] US$ 230 |
[ ] US$ 90 |
|
|
| Grand Total |
US$ |
*Student registration fee does not include dinner. Dinner tickets will be available at the registration desk for an additional fee.
|
[ ] |
I have enclosed a personal check, company check or bank draft in US Dollars for the above grand total payable to the order of
the 2003 VLSI Symposia. |
[ ] |
I have enclosed payment, in a form that has been agreed to by Widerkehr and Associates, in US Dollars for the above grand total
payable to the order of the 2003 VLSI Symposium. |
| Cancellation:If written notice of cancellation reaches the Japanese Secretariat: |
|
On or before May 16 |
Cancellation fee, US $45 will be deducted before refunding the fee. |
|
After May 16 |
No refund. A copy of the digest will be sent after the symposium. |
|