2001 IRPS Door Registration Form - April 30 - May 3, 2001
(Please type, print or attach business card)

NAME (last, first + initial): ___________________________,__________________________

company: ________________________________________mail stop: _____________

address: _________________________________________________________

city: ________________ state/country: ________________________zip/postal code: _________

phone: _____________________ fax: _________________________

email: ______________________________________________________________

Name for badge of companion (spouse, guest): _______________________________

Which WEDNESDAY NIGHT WORKSHOP will you attend ( 1, 2, 3, 4, 5, 6, 7, 8, 9)

DOOR REGISTRATION FEES*
*After April 13 and at the door,* After April 20 this form should be downloaded, filled out, and broght to the symposium. .

IEEE Member (incl. Mem # _______________ )  $350.* ______________
Society Membership:(circle one)   EDS    RS   Other ______
NON-IEEE Member ........................... $400.* ______________
Author • Student • Committee • RLM......... $280.  ______________
Extra Luncheon Tickets, Qty.____x .......... $ 25.  ______________ (for guests)
Extra 2001 Proceedings, Qty.___x .......... $ 40.  ______________
Extra 2001 Proc CDROM, Qty.___x ........... $ 40.  ______________
Tutorials: (Circle one or two in a.m. & one or two in p.m.)
a.m.: 1 2 3 4 5 p.m.: 6 7 8 9 10 11    ....... $290.* ______________
Set of video tapes of presentations ....... $150.**______________
**If non-USA shipping add $30
TOTAL REMITTED ................................. $ ______________

Method of Payment: (check one)


Bring to IRPS Registration in the Hampton Court Assembly at the Wyndham Palace Resort and Spa
Or if paying by credit card, fax to 315-336-9134 not later than April 20, 2001
Questions? reg@irps.org or at 315-339-3968