AIM '99 CONFERENCE REGISTRATION FORM

(PLEASE PRINT CLEARLY)

Name  ________________________________________________________________________________________

Social Security Number  _________________________________________________________________________
                                 (U.S. Attendees only; required for Lifelong Learning Tax Credits)

Position  ______________________________________________________________________________________

Organization  __________________________________________________________________________________

Address  ______________________________________________________________________________________
              (Note:  Registration confirmation will be sent to this address)

City  _______________________________________   State  ____________________________________________

Postal Code  _________________________________   Country  _________________________________________

Phone  ______________________________________  Fax  _____________________________________________

Email  ________________________________________________________________________________________

Name and Affiliation on Badge  ___________________________________________________________________

Member of:

[ ]	American Society of Mechanical Engineers (ASME)		ASME Member No.  ___________________
[ ]	IEEE Industrial Electronics Society (IES)			IEEE Member No.  ____________________
[ ]	IEEE Robotics and Automation Society (RAS)

MAIL this form to: 	Georgia Institute of Technology
                                           Continuing Education - R
                           	P.O. Box 93686
                                         	Atlanta, Georgia 30377-0686 USA
or
FAX it to:		+1 (404) 894-8925
or
EMAIL it to:		register@conted.swann.gatech.edu
or
PHONE to:		+1 (404) 894-2401  (between 9:00 and 16:00 EST)
			Have your credit card and registration form handy to aid in this process
or
ON-LINE at:		http://www.conted.gatech.edu/courses/aim99.html 

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CONFERENCE FEES

Advance Registration (until August 19, 1999)

[ ]  IEEE/ASME Members*			US$ 350
[ ]  Non-Members*				US$ 400
[ ]  IEEE/ASME Student Members*		US$ 200
[ ]  Tutorial (IEEE/ASME Members)		US$ 100
[ ]  Tutorial (Non-Members)			US$ 125
[ ]  Tutorial (Students)				US$ 75
[ ]  Luncheon**				US$ 35
[ ]  Riverboat Banquet*** at Stone Mountain	US$ 50
[ ]  Industrial Tours****				US$ 30		[ ] Industrial Tour 1    [ ] Industrial Tour 2
[ ]  Research Laboratory Tours			US$ 10
[ ]  Bound Proceedings				US$ 75

* Registration includes attendance to the Conference, the CD-ROM Proceedings containing the Papers and the Videos, access to the Luncheon, the Welcome Reception and the Farewell Party. 
** For each accompanying person wishing to attend the conference luncheon. 
*** Due to limited space, riverboat banquet will be available on a first-come, first-served basis with advance registration only.  Unless space is available after advance registration, there will be no on-site registration for banquet. 
**** Some tours may have security restrictions and, in those cases, on-site registration will not be permitted.  

On-Site Registration

[ ]  IEEE/ASME Members			US$ 400
[ ]  Non-Members				US$ 450
[ ]  IEEE/ASME Student Members			US$ 250
[ ]  Luncheon					US$ 35
[ ]  Industrial Tours				US$ 30		[ ] Industrial Tour 1    [ ] Industrial Tour 2
[ ]  Research Laboratory Tours			US$ 10
[ ]  Bound Proceedings (IEEE/ASME Members)	US$ 100
[ ]  Bound Proceedings (Non-Members)		US$ 150

PAYMENT INFORMATION

Grand Total US$  __________________________________
 	        (Sum of all entries checked above)

Charge		[ ] VISA	    [ ] Master Card     [ ] American Express	[ ] Discover

Card Number  _________________________________________________________   Expiration Date  ____________________

Cardholder's Signature  _____________________________________________________________________________________

or

Wire Transfer

Amount Sent  ____________________________________   Date Transfer Requested  __________________________________

Name of Bank  ___________________________________________________________________________________________

Nations Bank, Atlanta, GA, USA
Account No. 0100818229; Routing No. 061000052

or

Check or Money Order

Checks should be made in US funds, drawn on a US bank (otherwise there is an additional charge of US$ 50) and payable to Georgia Tech.