Regstration Form - SIVE95

First Workshop on Simulation and Interaction in Virtual Environments July 13-15, 1995. The University of Iowa

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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: includes lunch and dinner/reception
on Thursday, July 13, and conference materials and proceedings. 

ACM members: $100          Students: $50          Others: $125          

Amount enclosed: $_____________


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 

MAIL COMPLETED REGISTRATION FORM TO:

  SIVE95 Registration
  Computer Science Department
  MacLean Hall
  The University of Iowa
  Iowa City, Iowa 52242
 
OR FAX IT TO:

  (319) 335-3624