CSFW-16
30 June - 2 July 2002
Pacific Grove, CA, USA

To register, please fax or mail this form with payment by 24 June to:
IEEE Computer Society
CSFW-16 Registration
Dept. 6006
Washington, D.C..  20042-6006
Fax +1-202-728-0884 (Sorry, no phone registrations.)
Registration forms without payment will not be accepted.

Name:______________________________________________________________________________________
     Dr. Prof. Ms.  Mr.  Last/Family Name		First Name		MI

Company: __________________________________________________________________________________

Address:___________________________________________________________________________________

City/State/Province/Zip/Country:___________________________________________________________

Daytime phone:_________________ Fax:____________________E-mail:____________________________

Do not include my name, mailing/e-mail address, phone and fax numbers on the attendee list.
Do not include my name and mailing address on a mailing lists.

IEEE/Computer Society Member Number:_______________________________________________________

Full-time student certification (have advisor sign):_______________________________________

Please advise us if you have any special needs:____________________________________________

CONFERENCE REGISTRATION: includes admission to technical sessions and refreshment breaks.

Advance (received by 4 June)       	Late/On-site (received after 4 June)
Member:			U.S. $250	Member:		       U.S. $310
Nonmember:		U.S. $310	Nonmember:	       U.S. $400
Full-time student:  	U.S. $150      	Full-time student:     U.S. $150

TOTAL ENCLOSED:________________ Please make checks payable to: IEEE
COMPUTER SOCIETY.  All checks must be in U.S. DOLLARS drawn on
U.S. BANKS.  Credit card charges will appear on statement as "IEEE
Computer Society - Registration."  Written requests for refunds must
be received at the above address before 11 June.  Refunds are subject
to a US $50 processing fee.


METHOD OF PAYMENT: 	
_____Personal Check	______Company Check	_____VISA      	_____MasterCard
_____American Express	______Diners Club       	

Credit Card Number: _________________________________________________ Exp. Date: ______________

Cardholder Name: _______________________________Signature:_____________________________________