2004 IRW Registration Form - Mon., Oct. 18 - Thur. noon, Oct. 21

(Please type, print or attach business card)           (Use also for reserving accommodations to EIA/JEDEC Committee JC14.2 meeting, Oct. 21-22)

NAME (last, first + initial):___________________________,__________________________

company: _______________________________________________mail stop:__________________

address: _________________________________________________________

city: _______________________ state/country:______________________zip/postal code: __________

phone: __________________ fax: __________________ email: ___________________________

All attendees have the opportunity to present a poster to communicate their ideas and results on a technical project or issue. Please indicate your intention to bring a poster.You will be provided with a poster board for one of the poster sessions to share your ideas and your results on a technical topic or issue. Instructions will be sent to you if you register for a poster. You will be provided with a 32" x 40" poster board. For questions on posters contact: bknowlton@boisestate.edu.
(__) Will need a poster board for (Title:)___________________________________________________________________

I am interested in the following Discussion Group(s):
(__) Gate oxide reliability;    (__) NBTI;   (__) Interconnect Reliability;   (__) Product Reliability;
(__) My suggestion: ________________________________

REGISTRATION FEES (US$)

*The Workshop Registration Fee includes: 3 nights housing accommodations (Monday--Wednesday) at the Stanford Sierra Camp cabins, nine meals (dinner Monday--lunch Thursday) and refreshments (no-hostbar), on-site recreation activities, parking for your car, the Presentation Viewgraph Booklet (at the workshop), and the Final Report (after the workshop, printed and cd).
** The JEDEC Committee fee for accommodatons includes: housing on Thursday night, 3 meals (dinner Thursday -- lunch Friday), refreshments, and parking for your car.
***To promote student involvment at IRW, this year, we will be offering a reduced registration fee of $645 to the first 15 students who register. Students accepting the discount must be either IEEE members, or join the IEEE as a student member. It is also preferred that students are accompanied by a full fee paying professor or sponsor.
IEEE Member (incl. Mem # _______________ ) ..........$995.* ______________
NON-IEEE Member ................................... $1045.* ______________
SPONSORED IEEE STUDENT*** member (Mem# _____________)$645.* ______________
  (attending professor/sponsor: ____________________________)
Extra Workshop Final Reports (printed), Qty.___x ... $ 80.  ______________
Extra Workshop Final Reports (cd), Qty.___x ........ $ 80.  ______________
Extra Workshop Final Reports (printed & cd), Qty.__x $130.  ______________
JC14.2 accommodations ............................. $240.** _____________
TOTAL REMITTED ......................................... $ ______________
Meeting registration automatically includes a room reservation
Method of Payment: NO Wire Transfers(check one)
(__) Check: Make checks payable to: 2004 IRW
(__) Credit Card (check one):      (  )AMEX      (  )MASTER CARD      (  )VISA      (  )Diners Club

Card No.____________________________ Expiration Date:___________ Signature:__________________________

CANCELLATION fees: $50 after September 24; FULL FEE after October 8
Send to IRW Registration; P.O. Box 308; Westmoreland, NY 13490-0308; Or if paying by credit card, fax to 315-336-9134; Questions? becky@sar101.com or at 315-339-3968 NO Wire Transfers