WDAG'97 Registration Form (also in simple text, or postscript form)
 Please read the information brochure, then type/print clearly and send to:
 (if you use fax, please *do not forget* to also send the original by mail)
 WDAG'97 SECRETARIAT (Att. Roxane Wetzel)
 Max Planck Institut fuer Informatik                  FAX: +49-681-9325-999
 Im Stadtwald, D-66123 Saarbruecken, GERMANY.     

First Name_______________ Last Name__________________________ [ ] Ms [ ] Mr 

Affiliation________________________________________________________________

Address____________________________________________________________________

City______________________ Post-Code_____________ Country__________________

E-mail_________________________ URL________________________________________

Phone__________________________ Fax________________________________________ 

============================== FEES / PAYMENT / GRANTS ====================

Reg. Fee includes Proceedings, 3 Lunches, Conf. Dinner, Breaks, Soc. Program
                              Before August 22, 1997   After August 22, 1997  
   RegularFee / StudentFee(*)     435 DM / 335 DM           535 DM / 435 DM
(*) please also send a Student Certification, signed by your advisor
    
Amount Paying: _________  Way of Payment (please check one):
                          [ ] BankTransfer    [ ] Euro/MasterCard   [ ] VISA

 If you pay by BankTransfer, please send us also a photocopy of the Transfer 
 Order; if you pay by Credit Card, please fill in the following:
  
  Credit Card # ________________________ Expir. Date (month/year) __________

  Name of Card-Owner________________________________________________________
  I hereby authorize MPI-Informatik to debit my card for the amount above:

  Signature of Card-Owner___________________________________________________

Apply for a grant?   [ ] No     [ ] Yes: please E-MAIL (wdag97@mpi-sb.mpg.de)
  or FAX, by August 22, a brief CV (incl. your status, age and nationality)
  and a brief letter by your scientific advisor or ALCOM-IT site coordinator.

============================= MEALS / ACCOMMODATION ==========================
Do you prefer vegetarian meals?                        [ ] Yes        [ ] No 

Would you like us to reserve accommodation for you?    [ ] Yes        [ ] No
        (Please note that acommodation is *not* included in the registration
         fee; you can pay directly at the hotel when you are here.)

  # Nights____   Arr.: Sept.___'97 (Approx. time_____)  Depart.: Sept.___'97 

  Hotel group that you prefer:     [ ] Group I (Economy)        [ ] Group II 

  Room: [ ] single                 [ ] 2-bedded/double, own use

        [ ] 2-bedded, sharing with___________________________________________
        [ ] 2-bedded; please find for me someone to share the room with 

Date__________________________ Signature____________________________________