Preregistration Form (Mandatory fields = *)

Preregistration deadline: Wednesday, January 15, 2003

SIAM is pleased to offer secure ordering. If you are uncomfortable sending credit card information over the Internet via a secure socket connection, please print this order form, fill it out, and fax it to SIAM at (215) 386-7999. If paying by check, please make your check payable to SIAM and mail it with this filled-in form to SIAM, 3600 University City Science Center, Philadelphia, PA 19104-2688. For more information on alternative payment methods, please refer to How to Order SIAM Products.

AN E-MAIL CONFIRMATION WILL BE SENT TO YOU WITHIN 10-15 WORKING DAYS. If you do not receive it, SIAM has not processed your registration. Please contact if you do not receive an e-mail confirmation by February 3, 2003. Your printed receipt will be included in your registration packet on-site.

To ensure that your registration is processed correctly, please fill in the following form as accurately as possible. Make sure you include your credit card number and expiration date. Registrations received without payment will not be processed. Remember to push the submit button when you're finished! A pop-up message should appear saying "Thank you for filling in the form. Your response has been received by our server. Thank you for using the SIAM Web Server." This is not your registration confirmation. If you do not see this pop-up message, please contact for assistance.

All advance registration payments are to be made by credit card, check, or money order. All fees quoted are in U.S. dollars. To take advantage of preregistration rates, both Preregistration Form and payment must be received at the SIAM office by Wednesday, January 15, 2003.

Personal Information


*Male or Female:
(For Statistical Purposes only)

*Speaker Information:
*Organization type:
*Organization Name:

Please select only one of the registration fees below

Preregistration Deadline: Wednesday, January 15, 2003.

Short Course Registration Fees for February 9
Short Course Luncheon
Select Short Course registration fee:


If so, PLEASE select a Short Course Fee below:

*SIAM Activity Group on Computational Science and Engineering

Short Course Registration Fee Includes:

  • Two Coffee Breaks
  • Room set-ups and audio-visual equipment
  • Luncheon

CSE03 Conference Registration - February 10-13, 2003
Select CSE03 Conference registration fee:
*SIAM Activity Group on Computational Science and Engineering
Please select the events that you plan to attend
Welcome Reception - Sunday, February 9, 6-9 PM *
Poster Session and Dessert Reception - Tuesday, February 11, 8-10 PM

Minisymposium organizers and speakers will also be required to register at the SIAM ON-SITE member rate if they do not preregister.

To confirm, please type in the TOTAL dollar amount of the registration rate(s) you selected.
My registration fee is $ dollars.

Send all SIAM Correspondence to: Home Business
Update my SIAM records to reflect the above: Yes No
Are you disabled and require appropriate accommodations? Yes No

Handicap Symbol SIAM wishes to take steps to ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services. If you need any auxiliary aids or services identified in the Americans with Disabilities Act, or assistance in registering for this conference/meeting, please contact Coley Lyons by phone: (215) 392-9800; fax: (215) 386-7999 e-mail:; or mail: Society for Industrial & Applied Mathematics, 3600 University City Science Center, Philadelphia, PA 19104-2688.

Name Badge Information:

I prefer my name and affiliation to read as follows:

Name (20 Characters): *

Affiliation (20 characters): *

Payment Information: 

I wish to pay by: *

American Express Visa Master Card
Name as it appears on Credit Card:*
Credit Card Number: *

Expiration Date: *

Please submit this information to SIAM


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Created 9/19/02