APL98 Registration Form
--------------------------------------------

			Personal Information
			--------------------

Last Name:
	________________________________________________________

First-Middle Name:
	____________________________|___________________________

Title/Position:
	________________________________________________________

Company/Organization:
	________________________________________________________

Mailing Address-ZIP Code:
	____________________________|___________________________ 

City-State-Country:
	_______________|_________________________|______________

Telephone-FAX:
	____________________________|___________________________

e-mail:
	________________________________________________________



Accompanying person(s):

1. Last-First Name: 
	____________________________|___________________________

2. Last-First Name:
	____________________________|___________________________

3. Last-First Name:
	____________________________|___________________________

4. Last-First Name:
	____________________________|___________________________



Special Requirements. Please, give details of any
particular requirement (e.g. special diet, or else).
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			AMOUNT DUE CALCULATION
			----------------------
			    (Italian Lire)


ACM/SIGAPL member:	_ YES	_ NO	

ACM/SIGAPL membership number: ____________________________

Non member:	_ YES	_ NO

Student:	_ YES	_ NO

Type of registration:	_ Early    _ Late

Conference fee: _________________   

# accompanying persons:  ____ x Lit.180.000 

Accompanying person fee: _________________


Social events: 
Banquet:	_ YES	_ NO
               
# people:  ____ × Lit.90.000

Banquet fee: _________________    


More social events are under definition.
Reservation and subscription will be possible as soon as they 
become available. Please check the relevant web pages 
for event updates.


Total amount due: _________________   


Please, check your payment method:

__ Bank Draft to the order of

APL98 Rome - account nbr 708/31, c/o Banca di Roma, Agenzia 149,
	Via del Castro Laurenziano 9, 00161 Rome, Italy
	ABI 3002.3 - CAB 5089.8




__ Credit Card		_ Visa 		_ AmericanExpress
			_ MasterCard	_ EuroCard	


For security reasons you shouldn't sent your credit card number 
by electronic means, but you should instead fax to the Conference 
Secretary the special form that you should fill at the end of 
registration process. 

################### End of Registration Form ###################


APL98 Credit Card Information Form
--------------------------------------------

Last and First name (as appear on card):

	________________________________________________________


Credit Card:

	__ VISA				__ MASTER CARD

	__ AMERICAN EXPRESS		__ EURO CARD


Card Number:

	________________________________________________________


Expiration date:

	________________________________________________________


Amount (Italian Lire):

	________________________________________________________


Signature (as appears on card):

	________________________________________________________


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