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Print this page, fill out registration form below and send it prior to July 1, 2000
TO:
WORKSHOP REGISTRATION
Workshop on Design Issues in Anonymity and Unobservability
NAME: _____________________________________________________________
ORGANIZATION (Company, University or Institution): ________________
___________________________________________________________________
ADDRESS: __________________________________________________________
___________________________________________________________________
E-MAIL: ___________________________________________________________
PAYMENT: USD 110 PAYMENT METHOD: [ ] Check enclosed
[ ] Credit Card
DATE: __________ SIGNATURE: ______________________________________
FILL OUT ONLY IF PAYMENT BY CREDIT CARD:
CREDIT CARD NUMBER: ______________________________________
VALID THRU: ______ / ______ TYPE: [ ] Mastercard
[ ] Visacard
CREDIT CARD BILLING ADDRESS: ______________________________________
______________________________________
SIGNATURE: ______________________________________
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