Fourth SIAM Conference on Geometric Design
Preregistration Form

Note: If you use Fill-in Forms to register, SIAM will send you confirmation of your electronic registration within 10 working days. If you do not receive confirmation, please contact SIAM Customer Service at 215-382-9800 or 800-447-SIAM (toll free, USA only).

There is a "Submit Registration" button at the bottom of this fill-in form. If you don't see the button, or if any of the check boxes or fill-in blanks do not appear correctly, your Web browsing software is not capable of handling this form. If that is the case, you should register by one of the methods listed in the Registration Information.

Preregistration Form
Preregistration deadline: Friday, October 20, 1995

No refunds will be issued after October 20, 1995. 

Registration Fees

                                            SIAM        Non-
                                SIAG/GD*    Member      Member      Student
                                                               
**Workshop on CAGD         
Preregistration (before Oct 20) $70         $70         $100        $50
Registration (after Oct 20)     $100        $100        $130        $50
                          
Conference 
Preregistration (before Oct 20) $145        $150        $180        $30
Registration (after Oct 20)     $175        $180        $210        $30
                                                              
BBQ DINNER                      $35.00      $35.00      $35.00      $35.00
                                   
*Member of SIAM Activity Group on Geometric Design.
**Registration fees for the workshop include refreshments and workshop notes.

Option and Rate Selection

I fall into this category: SIAM Member Non-member Student

I would like to register for:

Conference
Workshop on CAGD
BBQ Dinner

Based on the registration fees chart above and the options I chose, my registration fee should be dollars.

Name, Address, and Phone Information

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Department:

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Please send all SIAM correspondence to the following address: Home Business

Please update my SIAM records to reflect the above: Yes No

Are you a disabled participant that requires appropriate accommodations? Yes No

Name Badge Information:

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Payment Information:

I wish to pay by: AMEX VISA Master Card

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Now, to submit your registration form to SIAM, press this button:

9/5/95