DIMACS Workshop Registration Form

DIMACS Workshop in Honor of Alan Hoffman

September 19 - 20, 2014

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. 

       

  

           Your First 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:
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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