17th IEEE/NPSS Symposium on Fusion Engineering
Registration Form
Name _________________________________ Day Phone __________________
Affiliation _______________________________________________________
Address _____________________________________________________________________________
_____________________________________________________________________________________
City State Zip Country
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Please check appropriate boxes
FEE AMOUNT ENCLOSED
Registration
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a) IEEE Member (before Aug. 30) |_| $345 _______________
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b) IEEE Member (after Aug. 30) |_| $440 _______________
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c) non-Member (before Aug. 30) |_| $395 _______________
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d) non-Member (after Aug. 30) |_| $490 _______________
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e) Retired Person, student, |_| $50 _______________
unemployed IEEE member *
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f) One-day Registration |_| $90 _______________
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EXTRA PROCEEDINGS |_| $90 _______________
Additional Symposium Activities(for guests, retirees and students)
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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.