17th IEEE/NPSS Symposium on Fusion Engineering
Registration Form


Name _________________________________ Day Phone __________________

Affiliation _______________________________________________________

Address _____________________________________________________________________________

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        City                 State              Zip             Country

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Please check appropriate boxes
                                                     FEE     AMOUNT ENCLOSED
Registration
                                              _
   a) IEEE Member (before Aug. 30)           |_|     $345    _______________
                                              _
   b) IEEE Member (after Aug. 30)            |_|     $440    _______________
                                              _
   c) non-Member (before Aug. 30)            |_|     $395    _______________
                                              _
   d) non-Member (after Aug. 30)             |_|     $490    _______________
                                              _
   e) Retired Person, student,               |_|      $50    _______________
      unemployed IEEE member *
                                              _
   f) One-day Registration                   |_|      $90    _______________
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EXTRA PROCEEDINGS                            |_|      $90    _______________

Additional Symposium Activities(for guests, retirees and students)
                                              _
   a) Opening Reception (Oct. 6)             |_|      $20    _______________
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   b) Mexican Fiesta (Oct. 7)                |_|      $40    _______________


                                       TOTAL ENCLOSED:   ___________________

* Reduced fee does not include additional symposium activities or proceedings

Registration payments can be made by check, credit card* (Discover, American Express, Diners, Visa or MasterCard), or by international wire transfer. Checks should be in U.S. dollars, drawn on a U.S. bank, and made payable to "IEEE/NPSS SOFE97". Credit card payments should be faxed to Ms. Siegrist as information sent on the internet is not secure. International wire transfers must include ALL information stated below. Registration cancellation will be honored if it is before Friday, September 12, 1997. Otherwise, no refund will be available. Refund checks will be available to the cancelled registrants no later than November 30, 1997. Name as it appears on card __________________________________________ Card # _______________________ Expiration Date: _____________________ Mail Form and Check or FAX form with credit card information to the Registration Coordinator: Ms. Theresa Siegrist IEEE Registration Coordinator General Atomics Phone: 619-455-3492 P.O. Box 85608, MS 13/351 FAX: 619-455-3569 San Diego, CA 92186-9784 e-mail: theresa.siegrist@gat.com International wire transfers should be made to: Sanwa Bank, ABA: 122003516 Account name: General Atomics Account number: 271305868 You MUST reference the IEEE/NPSS SOFE97 when sending funds. *Credit cards will not be reimbursed in case of cancellation. Attendees would receive a check instead.