Please save this document to a file, fill in the information and send it to
one of the addresses listed below.

3rd IMACS Conference on APPLICATIONS OF COMPUTER ALGEBRA (IMACS-ACA'97)

                              REGISTRATION FORM

PAYMENT MUST ACCOMPANY FORM AND MUST BE POSTMARKED BY SATURDAY, MAY 31
FOR EARLY REGISTRATION FEE TO APPLY

CANCELLATIONS must be received in writing by MAY 31 for REFUND
(less $20 handling fee)


____________________________________, ___________________________________
                  (Last Name)                  (First Name)

_________________________________________________________________________
Institution Full Unabbreviated Name

_________________________________________________________________________
Mailing Address

_________________________________________________________________________
City, State/Province, Zip/Postal Code

_________________________________________________________________________
Country

_________________________________________________________________________
Telephone                     Telefax                       E-Mail


CONFERENCE REGISTRATION (Check One):

       ____ to be paid by IMACS-ACA
       ____ vendor registration
       ____ $150 early IMACS member      (postmarked on or before May 31, 1997)
       ____ $165 early non-IMACS member  (postmarked on or before May 31, 1997)
       ____ $175 standard IMACS member       (postmarked June 1, 1997 or after)
       ____ $190 standard non-IMACS member   (postmarked June 1, 1997 or after)
       ____ $200 on-site IMACS member       (on-site in Maui)
       ____ $215 on-site NON-IMACS member   (on-site in Maui)

Method of Payment __________

Acceptable methods of payment:
       Credit Card (Mastercard, Visa)
       Money order
       Institutional check
       Personal check
Contact us if you need to 
All payments must be in US dollars (strongly preferred) or include
US $15.00 extra to cover currency exchange.

Make checks payable to IMACS-ACA'97.
Return completed registration form with payment to:

       IMACS-ACA'97 Conference          FAX: +1 (505) 277 5505
       Cotopaxi                         (credit cards only)
       1801 Quincy, SE            OR
       Albuquerque, New Mexico          Email: aca@math.unm.edu
       USA   87108-4427                 (credit cards only)

(Please send a note by email to aca@math.unm.edu no matter how you send the
payment as a confirmation)

For Credit Card Payment:

Card Type _______________________ # ________________________ Exp. Date ________

Card Holder Name (print) ________________________ Signature ___________________

(Email registration is preferred and does not require a signature)