DIMACS Workshop Registration Form

                    DIMACS Workshop Registration Form
                          Workshop on SPIN96 -- 
               2nd International SPIN Verification Workshop 
                Algorithms, Applications, Tool Use, Theory
			     August 5, 1996
     

Name:  ..................................

Title:  .................................

Affiliation:  ...........................      

Address:  ...............................

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Country: ................................

Phone:  .................................

Fax:  ...................................

Email:  .................................

Talk title/topic:  .....................................................

Will you want to give a software demo?  Yes ....  No ....  Maybe  ......

Other special needs: ...............................................

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Student: __   Faculty: __  Researcher: __  

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