CPM 2005 FORM by welcomegong1

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									                                              CPM 2005
                            16 Annual Symposium On Combinational Pattern Matching
                               th

                                       Jeju Island, Korea. June 19-22, 2005


                                         REGISTRATION FORM
              ** Please print, sign and send this form via fax or e-mail (a scanned image of this form).
                              Fax: +82-2-885-3141, Email: registration@theory.snu.ac.kr
1. Participant Information
   Name (First, middle and last):
   Title / Job:         □Prof. □Dr. □Mr. □Ms. □Mrs.       Others:
   Organization:
   Address:
   City/Province:                            Country:                       Zip Code:
    Telephone:                                                 Fax:
      E-mail:


2. Conference Registration Fees

                    Registration Fee            Before 25th May           After 25th May
                    □     Regular Attendee       400,000 (WON)              470,000 (WON)
                    □     Student                270,000 (WON)              340,000 (WON)

                    Additional person(s) for the conference dinner
                    □     Per Person               56,000 (WON)

** Registration fees include admission to all conference sessions, breakfast, lunch, tour, conference dinner, and a
  copy of the proceedings.
** Student attendees must provide official student identification (ID card, confirmation of department or etc.).


3. Payment Information
              Conference Registration Fee               WON:
              Additional Person(s)                      WON:
              TOTAL Fees                                WON:


                                □ Master                  □ Visa

    Name on Credit Card:                                              Expiration Date              /        (MM/YY)

    Credit Card Number:

          Signature:
                                                                                   * Do not write anything in the box below

                                                          *
4. Additional Information
    Payment Information: Registration procedure will be accomplished after confirming attendee’s full payment.
    Refund Policy: The Organization Office should be notified of cancellations in writing. Refund will not be
    accepted after 25th, May, 2005. Before that day, person who asks the cancellation must give us notice within 3 days
    after registration. If you cannot attend, you may send a substitute person with a written authorization for such a
    change.
    For Registration Form: Please send this form via fax or email. If you are going to send the form via email, you
    fill out the blank section, print the form, put your signature, scan the form, and send a scanned image of the form to
    registration@theory.snu.ac.kr
    For any question about registration or payment: send e-mail to registration@theory.snu.ac.kr


5. Contact Information
Website: http://theory.snu.ac.kr/cpm2005/
E-mail: registration@theory.snu.ac.kr
Fax : +82-2-885-3141
Telephone: +82-2-2220-1986

								
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