DIMACS Workshop Registration Form

From A=B to Z=60
Conference in Honor of Doron Zeilberger's 60th Birthday

May 27 - 28, 2010

Please register by filling out the following blanks.

When finished and you have checked the correctness of information, press the "send" button at the bottom of the form.

Attendance is limited to available space; please register early.


       

  Dates you plan to Attend: 
Your First Name: Your Middle Name: Your last Name:
Your Position:
Your Postal Address: (This information will be used for nametags & mailing lists) Name of organization: (University or Company Name)
Organization Type: Department: Street Address: City, State, Zip Code: Country:
Phone: Fax: E-Mail: Web page URL:
We would like to list the participant's name, affiliation and relationship with Dr. Zeilberger. Please select from the list: Your Relationship with Doron Zeilberger:

Comments: (i.e. dietary restrictions)





Please contact the organizer(s) directly if you would like to submit a paper or poster.

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