2002 IEEE Symposium on Security and Privacy Registration Form
 

Name: _______________________________________

Affiliation: ________________________________

Postal Address: _____________________________

_____________________________________________

_____________________________________________
 

Phone: ______________________________________

Fax: ________________________________________

Email: ______________________________________
 
 

Note: Address information will be distributed to attendees.
If you do not wish to have your address included in the attendees list, please check here __________
 

Please enter the appropriate registration category.  Payment must be included and must be
either by check in U.S. dollars, drawn on a U.S. bank and made payable to
"IEEE Symposium on Security and Privacy," or by credit card.  Dates are strictly enforced by postmark.
 
 

Advance registration (up to 6 April 2002)

__ Member:             $335.00

   IEEE or Computer Society Member #_____________________, required

__ Non-Member:         $420.00

__ Full-time students: $125.00

Late/on-site registration

__ Member:             $395.00

   IEEE or Computer Society Member #______________________, required

__ Non-Member:         $495.00

__ Full-time students: $150.00
 
 

Do you wish to present at a poster session or lead an evening discussion? [ ] Yes [ ] No

Do you require vegetarian meals? [ ] Yes [ ] No

Please indicate you method of payment by checking the appropriate box:

[  ] Check in U.S. funds drawn on a U.S. bank (PLEASE ENCLOSE WITH THIS FORM)

Credit card authorization: (Charges will appear on your statement as made
by the IEEE COMPUTER SOCIETY.  Your credit card number will be transmitted
to the IEEE over the Internet, using an SSL-protected link.)

[  ] Visa   [  ] Mastercard  [  ] American Express  [  ] Diners Club

Credit Card Number:

Card Holder Name:

Expiration Date:

Signature (required for credit card payments)
 
 

Mail registration to:

Bob Blakley
IBM Software Group
Tivoli Systems
11400 Burnett Road
Austin, Texas, 78758, USA

Or fax this form (credit card registrations only) to:

FAX +1-512-436-1191
 
 

NO REGISTRATIONS BY EMAIL.  NO REFUNDS.