Fifth International Conference on Principles and Practice of Constraint Programming
Registration Form

October 12-16, 1999
Alexandria, Virginia, USA

Also includes registration information for the post-conference workshops, October 16.
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Fax or send (no email registration please) this registration form with payment to

Ms. Julie Gladbach/CP99

Office of Events Management
MSN 3G3

George Mason University
4400 University Drive
Fairfax, Virginia 22030-4444

Fax: (703) 993-2112

For inquiries: jgladbac@gmu.edu, (703) 993-8844
Registration will be confirmed by email

Please Print or Type

First (given) name ____________________________ Middle initial ___________

Last (family) name ____________________________ Suffix ___________

Name for badge ______________________________________________________

University/Organization ______________________________________________________

Street Address ______________________________________________________

Address line 2 ______________________________________________________

City ________________ State/Province ________________________

Country ________________ Postal/Zip ________________________

Area code ________________ Phone ________________________

Email address ________________ Fax ________________________

Registration Fees:

Conference registration includes admission to the conference and all workshops, a copy of the proceedings, continental breakfasts, coffee breaks, welcome reception, luncheon, and the banquet/entertainment.
The student registration includes all the above except for the luncheon and banquet/entertainment.
Workshop-only registration includes admission to all the workshops (Oct 16), and continental breakfast and coffee breaks on Oct 16.
To receive student rate, students are required to fax/mail verification that includes advisor's name and signature (see below).
The guest package includes continental breakfasts, welcome reception, luncheon, and the banquet/entertainment.

	Fees received on/before September 27	Fees received after September 27	You Pay
Regular	$450	$525
Students	$80	$120
Workshop Only	$90	$90
Guest Package	$175	$175	x No. of guests _____ =
Extra luncheon ticket	$25	$25	x No. of extra tickets ____ =
Extra banquet/ent. ticket	$75	$75	x No. of extra tickets ____ =
			TOTAL Registration Fee =

Special Meal Request:

Vegetarian Meals ‡ I would like vegetarian meals ___ of my guests would like vegetarian meals

Payment Methods: Check or money order in US funds, payable to GMU/CP99, or VISA or Mastercard credit cards only

Cardholder Name: ________________________________________________

Please charge my ‡ Visa ‡ Mastercard ‡ Check or Money Order

Credit Card Account Number ____________________________ Expiration _______________

Arrival and Departure Information: In order for us to manage registration and other activities efficiently please let us know when you plan to arrive and depart

Expected Arrival Date: ________________ Expected Departure Date: _________________

SIGNATURE _________________________________________ DATE ____________

For Students Only:

Advisor’s Name Advisor’s Signature Date