Registration Form

1996 Workshop on Scenario and Traffic Generation for Driving Simulation

December 6-7, 1996
Marriott Courtyard at Walt Disney World
Orlando, FL

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Name _______________________________________

Affiliation ________________________________

Address ____________________________________

City/State/Zip _____________________________

Country ____________________________________

Telephone __________________________________

FAX ________________________________________

Email ______________________________________

Social Security No.: _______________________ (optional --- The U of I requests this to
                                              help in the processing of registrations)

REGISTRATION FEE: $100, includes lunch on Friday, December 6,
and conference materials.

CREDIT CARD PAYMENT:

Charge the following credit card:

VISA ___         Mastercard ___

Expiration date: ________________________

Account number: _________________________

Signature:_______________________________

PAYMENT BY CHECK:

Make check payable to: The University of Iowa 

FAX  COMPLETED REGISTRATION FORM TO:

  (319) 335-3624

OR MAIL IT TO:

  SCENARIO96 Registration
  Computer Science Department
  MacLean Hall
  The University of Iowa
  Iowa City, Iowa 52242