SHARCNET Fall Workshop 2004 Registration

Step 1: Your Information    Step 2: Fee Payment

Please fill out the following form, fields with (*) are required.

Given Name*:
Family Name*:
E-mail*:
Institution/Organization*:
If other, please specify:
Department*:
Position*:
If other, please specify:
Research Area/Specialty*:
Phone Number:
Address:
City:
Province/State:
Postal Code:
Country:

Sessions to attend:

I'll attend the following:
ONLY Tuesday session    (No charge for this session)
all but Tuesday session
all sessions
I'll bring a poster: Yes    No
If yes, title of the poster: