_________________________________________________________________

Registration:

All participants are requested to fill in the registration form and pay
the fees as indicated below. Participants living in Brazil should register
with the Brazilian Committee.
_________________________________________________________________

Advanced registration (before August 15, 1997):
General :  $80,   Students: $40

At the Conference:
General: $100,   Students: $50

SGI Minicourse
General: $300,   Students: $100

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                        REGISTRATION FORM

Participant's Name:

Organization:

Department:

Are you a student?

Address (address at school, if student):


City:                           State:                  Zip code:

Country:

Telephone:                      FAX:

e-mail:

Badge Information:
-----------------

Name:

Affiliation:

                      PAY USING CREDIT CARD OR CHECK

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Use US dollars only!

If Paying by Credit Card:
-----------------------
Please indicate whether  VISA,  MASTERCARD  OR  AMERICAN EXPRESS

Credit Card Company:

Cardholder's name:

Credit Card Number:

Expiration Date:

Amount to be charged:

Please send this form to LaVerna Armistead via -

        email, fax, or phone for credit card information:

        email: armistead@sciences.sdsu.edu
        fax:   (619) 594-6746
        phone:  (619) 594-6192
--------------------------
If Paying by Check:
        Make check payable to:   SDSU Pan American '97

surface mail for check:

        LaVerna Armistead, Pan Am '97
        San Diego State University, Mail Code 7720
        Department of Mathematical & Computer Sciences
        San Diego, CA 92182-7720

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You will be mailed a receipt.
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