TSD Registration Form --------------------- First name: _____________________ Middle initial(s): ______________ Family name: ____________________ [] male [] female Affiliation: ____________________ Address: ________________________ ________________________ ________________________ Postal code (and state): ________ Country: ________________________ e-mail: _________________________ fax: ____________________________ telephone: ______________________ Expected date of arrival: ______________________ Expected date of departure: ____________________ Conference fees must be paid before August 17, 1998 (the date of the deadline for submission of final versions of accepted papers). We would remind you that papers will only be published in the proceedings if the conference fee of the author has been paid by this date. Conference Fee --------------------------- I would like accommodation in: [] shared double room ...... $210.-- per person [] single room ...... $270.-- The fee includes registration fee, food, and accommodation. The registration fee ($80), included in the above, covers proceedings, refreshments, social events, and excursion). The full conference fee as given above includes breakfasts, lunches, and dinners Tue-Sat, and accommodation for 4 nights (September 22-26). I would prefer to share my room with:_______________ Additional Accommodation ------------------------ [] I would like to arrange for additional accommodation before/after the conference. (Only requests for the period between September 21 and September 28 can be honoured): From:________ to: __________, # of nights: ______ From:________ to: __________, # of nights: ______ total # of nights: ______ price per night: accommodation (and food) in shared double room: $40 per person accommodation (and food) in single room: $55 _______ total: Total fee: .............................................. $ _______ Method of payment (all payments in US dollars): ---------------------------------------------- [] VISA [] MASTERCARD/EUROCARD Please note that the amount your card will be charged depends on the actual exchange rate at the time of the transaction. Please print out this Text-Only Registration Form, sign it, and send it to: Faculty of Informatics MU TSD98, Eva Zackova Botanicka 68a 602 00 Brno, Czech Republic When sending paper mail, please be sure to use a service which is reliable and not notoriously slow from your particular country. When filling in the dates below, please write legibly. Amount to be payed: ________________ Cardholder's name: ---------------- Card no.: _________________ Exp: __/__/__ Signature:_____________________ [] Bank Cheque / Eurocheque Please make your cheque payable in US dollars to "Faculty of Informatics, Masaryk University", and send with this signed Text-Only Registration Form to: Faculty of Informatics MU TSD98, Eva Zackova Botanicka 68a 602 00 Brno, Czech Republic When sending paper mail, please be sure to use a service which is reliable and not notoriously slow from your particular country. Signature:_____________________ [] Bank transfer to Komercni banka, a.s. pobocka Brno-mesto nam. Svobody 21 631 31 Brno, Czech Republic SWIFT Code: KOMBCZPP Account Number: 85636621/0100 Details of Payment (Mandatory): 3375000598, < name > Be sure to clearly state 3375000598 and your name in Details of Payment. (Information for Czech participants: Details of Payment znamena variabilni symbol. Kvuli identifikaci budeme take potrebovat kopii vypisu z uctu, ze ktereho platbu posilate.) Amount of Payment : $ __________ Amount of Payment : __________ Kc For Czech participants (in accordance with current currency rate) Expected Date of Payment : ------------