DIMACS Workshop Registration Form
DIMACS Workshop Registration Form
2nd Conference for African-American Researchers
in the Mathematical Sciences (CAARMS)
June 26-28, 1996
The registration fee is $40 through June 20 or $50 afterwards.
Please enclose fee and make check payable to RUTGERS.
Name: .............................................................
Job Title: ................................ Student? .............
Address: ..........................................................
....................................................................
....................................................................
Phone: ............................................................
Fax: ..............................................................
Email: ............................................................
Number of nights you will be staying: 4? ..... 5? ..... Other? .....
Do you wish to share a room with another participant (Y/N)? ........
If yes, list name of participant below (or one will be assigned):
....................................................................
Are you planning to drive to the conference (Y/N)? .................
If yes, please list your license plate number to obtain a Rutgers
parking sticker (no charge) ........................................
The conference has limited funds to reimburse invited speakers and
poster presenters. We can also provide partial support for a limited
number of participants.
Are you requesting financial assistance (Y/N)? .....................
Other special needs: ...............................................
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Document last modified on November 2, 1998.