ASA/ICA `98 REGISTRATION FORM
[Complete and return with appropriate payment by Mail or Fax to: Acoustical Society
of America, 500 Sunnyside Blvd., Woodbury, NY 11797, USA; Fax: 516-576-2377.]
Please type or print clearly ASA member: __Yes __ No
_____________________________________________________________________________
Last Name (Surname) First Name Middle Initial
Name as it should appear on badge____________________________________________
Company/Organization_________________________________________________________
Street Address_______________________________________________________________
_____________________________________________________________________________
City State/Province Zip/Postal Code Country
Tel. Number__________________________Fax Number______________________________
E-mail Address_______________________________________________________________
Name of Accompanying Guest (for badge)_______________________________________
before after
16 March 16 Mar
FULL REGISTRATION $300 $350 $_______
Includes Sessions, CD-ROM Proceedings
Exhibits, Opening Ceremony Receptions, Cruise/Salmon Dinner
STUDENT/EMERITUS $150 $175 $_______
Includes Sessions, CD-ROM (send copy of your
Proceedings, Exhibits, Opening Student ID card
Ceremony, Receptions, Cruise/ with this form
Salmon Dinner
ACCOMPANYING GUEST $100 $100 $_______
Includes Exhibits, Opening
Ceremony, Receptions, Cruise/Salmon Dinner.
OPTIONS
BANQUET- Thursday evening # tickets______ x $45 ea. $_______
PROCEEDINGS (printed copy) # copies_______ x $35 ea. $_______
SHORT COURSE: $250 before 1 May /$300 after 1 May $_______
TOTAL REMITTANCE (U.S. Dollars) $_______
PAYMENT METHOD:
___ Check or money order payable to Acoustical Society of America
(Note: Checks must be drawn on a U.S. bank in U.S. Dollars. Non-U.S. bank drafts
and wire transfers will not be accepted.
__Visa __M/C __AmEx: Card #__________________________Exp Date_______
EVENT RESERVATIONS FOR PLANNING PURPOSES: Please check events that
are included in registration that you plan to attend:
____ Sat., 6/20 evening reception ___Mon, 6/22 social/reception
____ Sun., 6/21 Opening Ceremony ___Wed., 6/23 Cruise/Salmon Dinner
____ Guest will attend the Mon., 6/22 Guest Reception
Return to ICA/ASA `98 General
Information