REGISTRATION

CHARGES

The registration fee (including proceedings, coffee breaks, and one dinner/reception):

1600 FF for IFIP or IEEE members prior to October 31, 1998

1900 FF for IFIP or IEEE members for late registration

1900 FF for non IFIP or IEEE members prior to October 31, 1998

2200 FF for non IFIP or IEEE members for late registration

TOTAL PAYMENT: _____________________

Method of payment (delete as not applicable):

PAID BY Check (enclosed, payable to DNAC)

or

PAID BY Credit card (details below)

______________________________________________________________________CREDIT CARD DETAILS

Visa card and Master card

No. ________ ________ ________ ________

Expiry date ____ / ____

I authorise you to charge the sum of ______________ to my credit card

numbered as above

Signature ________________

Date ________________

______________________________________________________________________

YOUR DETAILS

Name _____________________________________________

Position (or job title) _________________________________________

Affiliation ____________________________________________

Address _____________________________________________

_____________________________________________

_____________________________________________

Country _____________________________________________

Phone # _____________________________________________

FAX # _____________________________________________

E-mail _____________________________________________

______________________________________________________________________

SEND THIS FORM

by post with check or credit card payment to:

Guy Pujolle
PRiSM, University of Versailles
45 av. des Etats-Unis
78000 Versailles, France
FAX: (33) 1 39 25 40 57

SEND YOUR INTENTION TO PARTICIPATE AT : mmns98@prism.uvsq.fr

______________________________________________________________________