ICRE '96 Conference Registration Form



Print this form, then complete and return it with your check (in U.S. dollars only) payable to ICRE '96 - IEEE Computer Society, or charge to your Mastercard or Visa using the form below. PLEASE MAIL OR FAX TO: ICRE '96 General Chair; Prof. Carl Chang; Department of EECS (M/C 154); Univ. of Illinois; 851 S. Morgan; Chicago, Illinois 60607; FAX: (312) 413-1386; Phone: (312) 996-4860; email: icre@eecs.uic.edu or ckchang@uic.edu

NAME(s): _________________________________________________________________________
           Last/Family            First          MI               Name on Badge

Company Name: ____________________________________________________________________

Address/Mailstop: ________________________________________________________________

City/State/Zip/Country: __________________________________________________________

Daytime Phone Number: ______________  Fax Number: ______________ email: __________

IEEE/CS Membership Number: _______________________________________________________

Conference Registration Late Conference Registration
Please circle the one applicable fee: (Before March 15, '96): (After March 14, '96):
IEEE Member 410.00 485.00
Non-Member 510.00 595.00
Non-Member (Save Money! Join IEEE-CS
Now
; Print this form; Fee includes $64 for membership and $31 for IEEE Software)
505.00 Not Applicable
Student Member of IEEE 205.00 255.00

Tutorial Registration Late Tutorial Registration
Please circle the one applicable fee: (Before March 15, '96): (After March 14, '96):
Tutorial #1 180.00 220.00
Tutorial #2 180.00 220.00
Both Tutorials 350.00 430.00

Please circle the one applicable fee: Hotel Deposit:
No Hotel Room Required None
Single (fill in form below; includes all meals) 115.00
Double (fill in form below; includes all meals) 160.00


Check here if you have any special needs. Please specify: ______________________________

Total Fees (Conferences, Tutorials & Hotel Deposit): $________________

Check: ________     Visa: ________     Mastercard: ________

Credit Card #: ____________________________________  Expiration Date: ____________

CardHolder Name: _________________________________________________________________

Signature: _______________________________________________________________________


ICRE Hotel Registration Form

Conference hotel is Cheyenne Mountain Conference Resort (CMCR), 3225 Broadmoor Valley Road, Colorado Springs, CO 80906; Phone: 719-576-4600. PLEASE MAIL OR FAX TO: ICRE '96 General Chair; Prof. Carl Chang; Department of EECS (M/C 154); Univ. of Illinois; 851 S. Morgan; Chicago, Illinois 60607; FAX: (312) 413-1386. Reservations made after March 14, 1996 are subject to higher rates and/or space availability. We require a deposit in advance as indicated above to guarantee reservation. Prices during conference are for Full American Plan (i.e. All meals included). Cancellations must be received by the general chair by April 1 to receive a full refund of the deposit. Check-in time is 4pm. Check-out time is 12 noon.

Room Rates Pre-ICRE (No Meals) During ICRE (3 Meals) Post-ICRE (No Meals)
Nights of April 11-13 Nights of April 14-18 Nights of April 19-21
Single Room $95.00 $115.00 $95.00
Double Room $60.00 per person $80.00 per person $60.00 per person

Number of Nights:  ________             ________             ________

Arrival Date: __________________  Departure Date: __________________ 
Check here if you need free hotel shuttle bus service from the airport.
Flight: __________ Time of Arrival: __________ Please call hotel when you arrive.

Check here to request a non-smoking room.


Save Money! and Join the IEEE-CS Now Print and Fill this form. Fee Includes $64 for membership and $31 for IEEE Software.