Please print out and send separate forms for each attendee.
IEEE International Workshop On Embedded Fault-Tolerant Systems
May 22-23, 1998, Boston University, Boston, MA
Please print or type
Name: ________________________________________________________________________ Last First Middle Title (circle one): Prof., Dr., Mr., Ms., Mrs. Affiliation: _________________________________________________________________ Mailing Address: _____________________________________________________________ City State Zip Country Telephone: _______________________________ Fax: ______________________________ Email: _______________________________________________________________________ Do you have any special needs?: ______________________________________________
Payment must be enclosed. Registrations will not be processed without payment. Please, make checks payable to EFTS'98 Boston. All Payments must be in U.S. Dollars.Advance (before May 8, 1998) Late/On-Site (after May 8, 1998) ___ IEEE Member US$220.00 ___ IEEE Member US$265.00 ___ Non-member US$285.00 ___ Non-member US$330.00 ___ Student US$100.00 ___ Student US$100.00 Registration Fee: Workshop: _______________________ Total Enclosed: _______________________
Mail registration form with payment to: Volker Strumpen, MIT Lab for Computer Science, 545 Technology Square NE43-218A, Cambridge, MA 02139, Phone: (617) 253-1531, FAX: (617) 253-0415, Email: strumpen@theory.lcs.mit.edu.
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