Please mail or email the following registration form to 
toci@dimacs.rutgers.edu

                    DIMACS Workshop Registration Form
                         September 14 & 15, 1995
           

Name:  ..................................

Title:  .................................

Affiliation:  ...........................      Student?  .............

Address:  ...............................

.........................................

.........................................

Phone:  .................................

Fax:  ...................................

Email:  .................................

Talk title/topic:  .....................................................

Will you want to give a software demo?  Yes ....  No ....  Maybe  ......

Special meal requirements:       Kosher ......  Vegetarian  .......

Other special needs: ...............................................

If driving, will you need a campus parking permit?  ....................