26th International Conference
INFORMATION TECHNOLOGY INTERFACES
ITI 2004
Cavtat / Dubrovnik, Croatia, June 7-10, 2004

REGISTRATION FORM



Last name, name, title______________________________________________
_______________________________________________________________
Institution_______________________________________________________
Address________________________________________________________
_______________________________________________________________
City_______________________Code________________________________
Country________________________________________________________
Phone______________________ Fax________________________________
E-Mail_________________________________________________________
__ I intend to participate in the Conference without a paper.
__ I intend to participate in the Conference with a paper and I shall submit
an electronic version and a hard-copy of the full paper.
Tentative title____________________________________________________
_______________________________________________________________
Coauthor(s)_____________________________________________________
Topic__________________________________________________________
__ I intend to participate in the Conference with a poster and I shall submit
an electronic version and a hard-copy of the poster abstract.
Tentative title____________________________________________________
_______________________________________________________________
Coauthor(s)_____________________________________________________
Topic__________________________________________________________
__ I intend to participate in the BIOSTAT School of Biometrics.
__ I intend to organise a tutorial/workshop and to submit a short description.
__ I intend to demonstrate hardware/software and to submit a short description.

Please check all categories that apply (see the registration fee information):
__ I am a member of IMACS;
__ I am a member of IEEE;
__ I am a student.

Date____________________Signature________________________________

We prefer Internet registration.
Alternatively, fill in completely and send this form by regular mail or fax
to the Conference Secretariat before March 1, 2003.


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