2011 IRW Registration Form - Sun., Oct. 16 - Thur. noon, Oct. 20

(Please type, print or attach business card)

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

company: _____________________________________________mail stop:_______________

address: _________________________________________________________

city: ____________________ state/country:____________________zip/postal code: _________

phone: __________________ fax: __________________ email: ___________________________

  • For rooming assignments please check one:
    /__/ male     /__/ female
  • /__/Address is HOME
  • /__/ Please check here if you do not wish to receive mail other than from IRW/IRPS
  • /__/Please check here if physically challenged and you require any auxiliary aids or services. Please call (315) 339-3971

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: Tibor Grasser, grasser@iue.tuwien.ac.at.
(__) Will need a poster board for (Title:)_______________________ ____________________ ___________

REGISTRATION FEES (US$)

IEEE Member (incl. Mem # _______________ ) ..........$1625.* ______________
NON-IEEE Member .................................... $1775.* ______________
STUDENT Member** (Mem# _____________).................$875.* ______________
STUDENT NON-IEEE Member** ............................$975.* ______________
After 30 Sept. 11 add late fee:.......................$100. ________________
*The Workshop Registration Fee includes: 4 nights housing accommodations (Sunday--Wednesday) at the Stanford Sierra Camp cabins, 12 meals (dinner Sunday--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).
** To promote student involvement at IRW and in IEEE, we will be offering a reduced registration fee of $875 for IEEE member and $975 for non-member students who register. To join go www.ieee.org/join/ 		 
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.  ______________
TOTAL REMITTED ......................................... $ ______________
Meeting registration automatically includes a room reservation
Method of Payment: NO Wire Transfers(check one)
(__) Check: Make checks payable to: 2011 IEEE/IIRW
(__) Credit Card (check one):      (  )AMEX      (  )MASTER CARD      (  )VISA      (  )Diners Club

Card No.____________________________ Expiration Date:___________ Signature:__________________________

CANCELLATION fees: $50 after September 23; FULL FEE after October 7
Send to IRW Registration; 6106 Bartlett Road; Rome, NY 13440-1304; Or if paying by credit card, fax to 315-336-9134;
Questions? Email: becky@sar101.com or phone: 866-701-6614 or 315-339-3971 NO Wire Transfers