SIAM Southwestern Regional Mathematics in Industry Workshop, April 27-28, 2001, Hilton University of Houston, Hotel, Houston, Texas

Workshop Registration Form

Registration deadline: April 15, 2001
                             First                                  Middle Initial                              Last   
E-mail ________________________________________________________________________  
Please circle  only one of the registration fees below:

Regular:  $50.00
Student: $10.00
Registration fee includes lunches and refreshments  
Total Registration Fee ____________

I am a speaker in (circle):    Minisymposium     Contributed 

Name Badge Information:  
I prefer my name and affiliation to read as follows: 
Name  (20 Characters)______________________________________________
Affiliation  (20 characters)___________________________________________
Payment Information:  
Please make checks payable to "University of Houston" and mail registration form with fee by April 15 to
Professor Tsorng-Whay Pan
Department of Mathematics
University of Houston
Houston, TX 77204-3476  

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