DIMACS Workshop Registration Form

To register, please email this form to Pat Pravato, pravato@dimacs.rutgers.edu, or send it by postal mail to:
Workshop Coordinator
DIMACS Center
P.O. Box 1179
Busch Campus
Rutgers University
Piscataway, NJ 08855-1179 USA


                    DIMACS Workshop Registration Form
  Workshop on Network Design: Connectivity and Facilities Location
			  April 28 - 30, 1997
     

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

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

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

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

.........................................

.........................................

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

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

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

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

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

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

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

To help us improve publicity and to gather information requested by
sponsors, please answer the following:

Is your position primarily:

Student: __   Faculty: __  Researcher: __  

Is your home institution:

University: __  Corporate Lab: __  Government Lab: __  

Other (Please describe):. ..............................................

How did you hear about this workshop: ..................................


Please email this form to:
     pravato@dimacs.rutgers.edu

or send by regular mail to
     Workshop Coordinator 
     DIMACS Center 
     P.O. Box 1179 
     Busch Campus 
     Rutgers University 
     Piscataway, NJ 08855-1179 


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Document last modified on September 30, 1996.