[comp.lang.smalltalk] CHI'90 REGISTRATION FORM

armstron@bmers11.uucp (Steve Armstrong) (01/23/90)

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              CHI'90 REGISTRATION FORM
              ------------------------

 Registration may be completed in advance by mailing the
 registration form and fee so that the are postmarked by March 16,
 1990.  Reduced rates will be applied for registration form and fee
 postmarked on or before February 23, 1990.

 Registration forms will be processed only if accompanied by full
 payment. Registration forms and payments submitted separately will
 be returned. Registration forms sent by FAX must be paid for by
 credit card.

 Email Advance Program and Housing Forms may be obtained by sending a
 request to:
             meads.chi@xerox.com



 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
 *   NO PHONE OR EMAIL REGISTRATIONS WILL BE ACCEPTED!           *
 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

 Registration is also available at the door.


 PAYMENTS:
 --------
 Payments may be made by travelers checks, personal or company
 checks, money orders, or credit cards.  Payments from foreign
 banks must be made in U.S. dollars by either International Money
 Order or by drafts drawn against an account at a U.S. bank.

 Please make checks payable to:  CHI'90

 Purchase orders and government vouchers will not be accepted.


 REFUNDS/TRANSFERS:
 -----------------
 Refund requests must be made in writing and postmarked before
 March 16, 1990.  Regrettably, processing cost requires a 10%
 cancellation fee.  Registrations can be transferred by giving your
 substitute the conference registration confirmation receipt.


 RETURN REGISTRATION FORM AND FEE TO:
 -----------------------------------
 R. K. Yamauchi
 CHI'90 Registration
 P.O. Box 808, L-307
 Livermore, CA   94550

 Street Address:  Bldg 218, Room 110, L-307
                  7000 East Avenue

 Telephone:  (415) 422-4178
       FAX:  (415) 423-4021

 ===========< CUT HERE - Start of Registration Form >==============

 CHI'90 REGISTRATION FORM
 ------------------------

 Mailing Address (check one):  __ Business   __ School   __ Home

 ________________________________________________________________
 First Name             Middle Initial            Last Name

 ________________________________________________________________
 Name as you want it to appear on your badge (if different)

 ________________________________________________________________
 Department

 ________________________________________________________________
 Company or School Affiliation

 ________________________________________________________________
 Street Address

 ________________________________________________________________
 City          State/Province             Postal Code     Country

 ________________________________________________________________
 Telephone Number (Please include country, area and city codes)

 ________________________________________________________________
 FAX (optional)

 NOTE:  The conference attendee list may be made available to
        outside organizations. Check here if you DO NOT want your
        name to appear on this list.   _______


 =================================================================

 Society membership:

 Members of any of the following cooperating societies qualify for
 membership rates.  Please check all of which you are a member:

   __ ACM        __ IEEE-CS/CDE  __ Euro. Assoc. Cog. Erg.
   __ SIGCHI     __ IEEE-CS/OS   __ Div. 21 of APA
   __ SIGGRAPH   __ IEEE-CS/SE   __ Cog. Sci. Soc.
   __ SIGOIS     __ HFS          __ BCS-HCI
   __ SIGCAPH    __ NGI          __ Soft. Psy. Soc.


 Registration category:  Check one

   __ Member of cooperating society
      Society & ID#: ____________________________________________

   __ Non-member

   __ Full time student
      School & ID#: _____________________________________________
         (A current student ID must be presented at registration)

 =================================================================

 Tutorial Selections:  Check first choice selections


 Tutorial              Units         Tutorial              Units
  no.                                 no.

 __  1 Sunday all day    2            __ 19 Monday all day    2
 __  2 Sunday all day    2            __ 20 Monday all day    2
 __  3 Sunday all day    2            __ 21 Monday all day    2
 __  4 Sunday all day    2            __ 22 Monday all day    2
 __  5 Sunday all day    2            __ 23 Monday all day    2
 __  6 Sunday all day    2            __ 24 Monday all day    2
 __  7 Sunday all day    2            __ 25 Monday all day    2
 __  8 Sunday all day    2
                                      __ 26 Monday morning    1
 __  9 Sunday morning    1            __ 27 Monday morning    1
 __ 10 Sunday morning    1            __ 28 Monday morning    1
 __ 11 Sunday morning    1            __ 29 Monday morning    1
 __ 12 Sunday morning    1            __ 30 Monday morning    1
 __ 13 Sunday morning    1            __ 31 Monday morning    1

 __ 14 Sunday afternoon  1            __ 32 Monday afternoon  1
 __ 15 Sunday afternoon  1            __ 33 Monday afternoon  1
 __ 16 Sunday afternoon  1            __ 34 Monday afternoon  1
 __ 17 Sunday afternoon  1            __ 35 Monday afternoon  1
 __ 18 Sunday afternoon  1            __ 36 Monday afternoon  1
                                      __ 37 Monday afternoon  1
 ----------------------------       -----------------------------
   Total Sunday units _____           Total Monday units _____
      (Maximum of 2 units)               (Maximum of 2 units)

   Total tutorial units ____
          Sunday plus Monday (Maximum of 4 units)


 If, by some chance, a tutorial selection is not available, an
 alternate will be assigned only if you provide a prioritized list
 of alternates below:

 _________________________________________________________________

 =================================================================

 Conference and              |Postmarked on or| Postmarked     |
 tutorial fees:              |before Feb. 23  | after Feb. 23  |
 ----------------------------|-------+--------|--------+-------|
                    |Student | Member| Non-   | Member | Non-  |
                    |        |       | member |        | member|
 -------------------|--------|-------|--------|--------|-------|
 Conf Reg Only      |    $75 |  $245 |  $295  |  $340  | $390  |
 -------------------|--------|-------|--------|--------|-------|
 Conf +1 Tut'l Unit |    140 |   370 |  450   |   520  |  600  |
 Conf +2 Tut'l Units|    205 |   495 |  605   |   700  |  810  |
 Conf +3 Tut'l Units|    270 |   620 |  760   |   880  | 1020  |
 Conf +4 Tut'l Units|    335 |   745 |  915   |  1060  | 1230  |
 -------------------|--------|-------|--------|--------|-------|
 1 Tut'l Unit Only  |     65 |   165 |  195   |   220  |  250  |
 2 Tut'l Unit Only  |    130 |   330 |  390   |   440  |  500  |
 3 Tut'l Unit Only  |    195 |   495 |  585   |   660  |  750  |
 4 Tut'l Unit Only  |    260 |   660 |  780   |   880  | 1000  |
 ---------------------------------------------------------------

 Conference and tutorial fees:                        $________

 Local Showcase/Industry Tour:                        $________
  (@$75 per person X ____ person(s))

 Set of all the CHI '90 tutorial notes:               $________
  ( @ $495 per set -- must be accompanied by     )
  ( conference registration.  The set of tutorial)
  ( notes must be picked up at the conference.   )
  ( For your convenience, a shipping service will)
  ( be available.                                )


                                         Total fees   $_______


 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
 *  Regretfully, we cannot process any form without accompanying *
 *  payment.  PURCHASE ORDERS and GOVERNMENT VOUCHERS cannot be  *
 *  accepted.                                                    *
 *                                                               *
 *  Registration forms sent by e-mail CANNOT be accepted!        *
 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

 Please make check payable to:  CHI '90

 Payment by credit cards will be accepted:

       __ VISA      __ MasterCard     __ American Express

 _________________________________________________________________
 Credit Card Number                                Expiration Date

 _________________________________________________________________
 Signature                                         Date

 _________________________________________________________________
 Please print the name on the credit card, if it is different from
 the attendee's name.

 _________________________________________________________________
 If the credit card is a company card, please print the billing
 address

 -----< End of Registration Form >---------------