| 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.