Research Program Registration Form

Dates you plan on attending:
    Last Name:
   First Name:                             Middle Initial:
  Institution:
   Department:
Address (As it should appear on a mailing label,
include ZIP and country if not USA):

    Telephone:
   Fax Number:
       E-mail:
          URL:

No fee for registration.

NOTE:  Once your registration form is received, you will receive
information regarding travel, local hotels and meals during the
institute.

Questions? Please email Christine Spassione at dci@dimacs.rutgers.edu.

DIMACS Rutgers, The State University of New Jersey
Busch Campus / CoRE Building / 4th floor
96 Frelinghuysen Road
Piscataway, NJ 08854-8018
USA

TEL: (732) 445-4304
FAX: (732) 445-5932