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					                                  SIGCSE 2011 REGISTRATION FORM
               (On-line registration is available – see https://www.regonline.com/sigcse2011)

Please print all requested information clearly.

Full name ________________________________________________________________________________

Full name as you would like it on your badge ____________________________________________________

Company or school ________________________________________________________________________

Address _________________________________________________________________________________

City _____________________________ State/Province _________________ Zip/Postal Code ____________

Country ________________________________ Daytime phone number ______________________________

Home phone number ______________________________ Fax _____________________________________

E-mail _____________________________________________ ACM membership number _______________

 Special services required (specify)____________________________________________________________
 Check here if you are attending the SIGCSE Symposium for the first time.
   Check this box if you will be attending the free first timers’ luncheon on Thursday, March 10. This is
     encouraged for all first timers (no students, sorry) and entails no additional charge. Please indicate your
     meal preference:  Timberline Pot Roast                       Baked Vegetable Lasagna
 Check this box if you are a K-12 teacher.
 Check this box to opt-out of having your name on an attendee directory. (We ask you not to check this box.
  Supporters limit their contact to the list, and providing the list is an important piece of the thanks that SIGCSE
  provides for supporters’ critical financial support of the symposium, which keeps your costs low!)

Registration Type:           ACM or SIGCSE member  Non-member
Special Status Information:  Conference Committee       SIGCSE Board  Honoree  Student
                             Friday Only K-12 Teacher  Special Guest  Exhibits Only
                             Friday & Saturday Only K-12 Teacher

All conference registrations except Fri Only/ Fri & Sat Only K-12 Teacher and Exhibits Only include
one ticket to the Thursday evening reception. So that we can better prepare, please check one box:
    I will attend the reception  I will not attend the reception
All conference registrations except Friday Only K-12 Teacher and Exhibits Only include one ticket to the
Saturday luncheon. So that we can better prepare, please check as appropriate:
    I will attend the luncheon. My meal preference is:  Herb Crusted Chicken Breast  Eggplant Parmesan
    I will not attend the luncheon.
 Check if you are interested in participating in the robot rodeo, no robot experience necessary. See
  http://elvis.rowan.edu/~kay/sigcse/rodeo.html.
Free Pre-Symposium Events on Wednesday, March 9 (Choose up to 1) (First come first served)
 Microsoft Research’s Project Hawaii (limit of 125)
 Programming with Alice Workshop (Alice 2.2) (limit of 40)
 Programming with Alice Workshop (Alice 3) (limit of 40)
 Program by Design: Bootstrap, TeachScheme, ReachJava, and Beyond (limit of 40)
 SIGCAS meeting (AM)  Teaching Computer Ethics in the CS Curriculum (PM) (limit of 25)  Both
                              REGISTRATION FEES AND PAYMENT INFORMATION

Conference registration fee (from fee table) ....................................................................................$ __________

Workshops
You should also use this registration form to pre-register for symposium workshops. Workshop registration
requires a separate fee and the fee is for each workshop attended. Workshop descriptions are available on the
conference web site. Please note that some workshops require participants to bring a laptop.

Workshop registration fees (from fee table). Circle workshops you are registering for. ..................$ __________

     Wednesday: 1             2 3 4          5 6       7 8 9          10 11         12

     Friday:             13 14        15     16 17 18 19                20 21         22    23 24         25

     Saturday:           26 27 28             29 30 31 32                33 34 35

Miscellaneous

_____ Department Chairs Pre-Symposium Workshop (Wednesday, March 9) @ $100 ...................$ __________
_____ New Educators Roundtable (Wednesday, March 9) @ $25 ....................................................$ __________
_____ SIGCSE Membership @ $25 (Student @ $8) (permits registration at member rates) ...........$ __________
_____ Additional tickets for Saturday luncheon @ $40 each ...........................................................$ __________
     (Note: 1 luncheon ticket is included with all registrations except Exhibits Only and Friday Only K-12 Teacher)
             (Indicate quantity for each additional meal: ____ Herb Crusted Chicken Breast                                   ____ Eggplant Parmesan
_____ Additional tickets for Thursday reception @ $25 each ..........................................................$ __________
     (Note: 1 reception ticket is included with all registrations except Exhibits Only and Fri/Fri&Sat Only K-12
      Teacher)
_____ Additional copies of the CD version of the Proceedings @ $10 each....................................$ __________
     (Note: 1 copy of the CD proceedings is included with all registrations)
_____ Print version of the Proceedings (not included in registration) @ $40 each ........................$ __________

_____ Pokens @ $15 each (see http://www.sigcse.org/sigcse2011/attendees/pokens.php) ......$ __________

Total Payment Due ...........................................................................................................................$ __________

Payment Method
      Check enclosed made payable to ACM – SIGCSE 2011
      Charge my credit card:  MasterCard                         Visa         American Express

           Card # _________________________________________________ Expiration Date ______________

           Security # on back of card: __________ Signature __________________________________________
  Mail this form (and your payment) to: SIGCSE 2011 Registration, Department of Computer Science
          and Software Engineering, Campus Box 100, Rose-Hulman Institute of Technology,
                        5500 Wabash Avenue, Terre Haute, IN 47803-3920 USA
If paying by credit card, this form, including credit card information, may be faxed to +1-812-872-6060.
     Early registration MUST be faxed or postmarked by January 31, 2011.
     Late registration applies to all registrations faxed or postmarked on or after February 1, 2011. Late
      registrations MUST be received by February 28, 2011.
     On-site registration applies to all registrations received on or after March 1, 2011.

Fee Table - All amounts listed are in United States dollars.

                     Conference Registration                            Member            Non-member**
    Early Registration (through 1/31/11)                                  $235                $295
    Late Registration (2/1/11-2/28/11)                                    $275                $335
    On-site Registration (on or after 3/1/11)                             $315                $375
    Student                                                                $40                $50
    *Friday Only K-12 Teacher (through 1/31/11)                            $85                $85
    *Late Friday Only K-12 Teacher (on or after 2/1/11)                   $110                $110
    *Fri. & Sat. Only K-12 Teacher (through 1/31/11)                      $150                $150
    *Late Fri. & Sat. Only K-12 Teacher (on or after 2/1/11)              $175                $175
    *Exhibits Only                                                         $50                $50


                                       Registration
              Workshops                                       Miscellaneous
                                           Fee
                                                              SIGCSE Membership $25
     Early (through 1/31/11)                $65               Student SIGCSE Membership $8
                                                              Extra CD Proceedings $10
                                                              Printed Proceedings $40
     Late (2/1/11-2/28/11)                  $80
                                                              Extra Reception Tickets $25
                                                              Extra Luncheon Tickets $40
     On-site (on or after 3/1/11)           $95               Dept. Chairs Pre-Symposium Workshop $100
                                                              New Educators Roundtable $25
                                                              Registration Cancellation fee $75
*Note that Friday Only and Friday & Saturday Only K-12 Teacher registrations and Exhibits Only registrations
do not include a ticket for the Thursday reception. Friday Only K-12 Teacher registrations and Exhibits Only
registrations do not include the Saturday luncheon.
**SIGCSE membership costs only $25 and allows you to save $60 on your conference registration fee. You can
join SIGCSE by checking the appropriate line under Miscellaneous on the previous page.
Note that student rates are for full-time students only and do not have a late penalty.
Cancellations and Refunds: All cancellation and refund requests must be received by February 28, 2011.
Requests may be e-mailed to sigcse2011@csse.rose-hulman.edu, faxed to +1-812-872-6060, or mailed to SIGCSE
2010 Registration, Department of Computer Science and Software Engineering, Campus Box 100, Rose-Hulman
Institute of Technology, 5500 Wabash Avenue, Terre Haute, IN 47803-3999 USA. No refunds will be issued for
cancellations received after February 28, 2011. A US$75 processing fee will be charged for all cancellations.
This amount will be deducted from your refund.

				
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