TSD Registration Form
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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
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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
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[] 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):
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[] 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 : ------------