MICS 2002 Registration Form

Mail to:

Mark Fienup

Computer Science Department

University of Northern Iowa

Cedar Falls, Iowa 50614-0507

Name:

Address:

City:

State:

Zip:

Phone:

Fax:

E-mail:

School/Organization:

Register me for: (Please circle)

By

March 22

After

March 22

Faculty

Staff

Full conference registration

$85

$100

Friday only registration

$50

$55

Saturday only registration

$50

$55

Student

Full conference registration

$28

$35

Friday only registration

$15

$20

Saturday only registration

$15

$20

Additional Friday pizza party tickets ($5 each) Number:_____

Subtotal:

 

Additional Saturday lunch tickets ($15 each) Number:_____

Subtotal:

 

Total:

 

Check here if you have any special needs (including dietary). Please describe your

special needs:__________________________________________________________

Check here if you need a parking permit for Friday afternoon on the UNI campus.

 

Payment information:

This year we will only be able to accept checks or cash. Please make checks payable to

"UNI - MICS".