5th Conference on Algorithms
and Complexity
May 28-30, 2003 Rome, Italy
Registration form
Please, send the completed form by e-mail to ciac2003@dsi.uniroma1.it
(preferable) or by fax to +39-06-8541842.
A payment proof is also required in order to complete the registration.
Please, send it by fax to +39-06-8541842.
Payments can be made by bank transfer (Banca di Roma, Agenzia n° 208, Via Po 52, 00198 Roma, account number 651237/38, SWIFT number BROMITRF046; for Italian participants only: ABI 3002/3, CAB 05016/1). Please make sure to specify "CIAC 2003 registration" in the bank transfer and that the bank transfer is made net of all bank charges and commissions.
Name: _________________________________________________________________________________________________
Affiliation (as it should appear on the name tag): ______________________________________________________________
Address: _______________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Telephone (including country code): _________________________________________________________________________
Fax n.: _________________________________________________________________________________________________
E-mail: ________________________________________________________________________________________________
Are you a student? _______ Yes _______No
Are you author of an accepted paper? _______ Yes _______No
If yes, please specify the title: ______________________________________________________________________________
______________________________________________________________________________________________________
Special Requests (meals, discapacities): ______________________________________________________________________
______________________________________________________________________________________________________
Payment information:
|
Early Registration
(before March 20) |
Late Registration
(after March 20) |
|
_______ Student fee: € 120
|
_______ Student fee: € 170
|
|
_______ Normal fee: € 320
|
_______ Normal fee: € 370
|
|
Additional tickets for social events
|
|
|
_______ Students: € 60
|
_______ Accompanying persons: €
100
|
Total payment: _________________________
Date of payment: _________________________
Fax: +39-06-8541842
E-mail:ciac2003@dsi.uniroma1.it