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					                                 Registration Form

         Third International Conference on Cognitive and Neural Systems

                   Department of Cognitive and Neural Systems
                               Boston University
                               677 Beacon Street
                          Boston, Massachusetts 02215
                             Tutorials: May 26, 1999
                            Meeting: May 27-29, 1999
                               FAX: (617) 353-7755

                              (Please Type or Print)

    Mr/Ms/Dr/Prof:
    ^^
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    Name: Norbert Kopco
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    Affiliation: CNS Dept., Boston University
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    Address: 677 Beacon St.
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    City, State, Postal Code: Boston, MA 02215
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    Phone and Fax: 617 353 9683
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    Email: kopco@bu.edu
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The conference registration fee includes the meeting program, reception,
two
coffee breaks each day, and meeting proceedings. The tutorial
registration
fee includes tutorial notes and two coffee breaks.

CHECK ONE:

    [ ] $70 Conference plus Tutorial    [x] $30 Conference Only
    (Regular)                           (Student)
    [ ] $45 Conference plus Tutorial    [ ] $25 Tutorial Only (Regular)
    (Student)
    [ ] $45 Conference Only (Regular)   [ ] $15 Tutorial Only (Student)

Method of Payment: (Please FAX or mail)
[ ] Enclosed is a check made payable to "Boston University". Checks must
be
made payable in US dollars and issued by a US correspondent bank. Each
registrant is responsible for any and all bank charges.

[x] I wish to pay my fees by credit card (MasterCard, Visa, or Discover
Card
only).

 Nam: Norbert Kopco      Acc #: 4118 5300 0036 9279
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 Type of card: VISA                                Expiraton date: 12/01
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 Signature:                                        Date: 2/8/99
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Inquiries to Cynthia Bradford cindy@cns.bu.edu
Maintained by Diana Meyers diana@cns.bu.edu

Last updated: August 6, 1998

				
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