REGISTRATION FORM

IEEE APC 2002 Workshop
April 29, 30 and May 1, 2002
"Advanced Process Control Applications for Industry"

Cost ($CA)   IEEE Member* (Early bird**) $300 Non-Member* (Early bird**) $375 IEEE Member* $350 Non-Member* $425 Student* (Non-Member) $200 Student* (Member) $150 Exhibitor (includes one registrant)* $450 Conference proceedings only $30

Date: __________________________

Name: __________________________ Company: __________________________________

Mailing Address: _____________________________________________________________

Phone: ______________________________ Fax: __________________________________

E-mail: ___________________________________

Member  Yes    No    IEEE Membership # : ________________________________

Credit Card type: ______________ (VISA, MC, AMEX)

Card #: _____________________________________ Expiry Date (mo/yr): _____________

Card Holder's name: _________________________________________

Signature: ___________________________________ Payment amount ($CA) : ___________

Do you intend to stay at the Sutton Place Hotel?   Yes    No

If not prepaid, please confirm attendance before April 5, 2002 with Sharon Pirnak at 604-214-9248 to hold your space. You may also make your payment by cheque payable to: IEEE APC2002 Workshop and send with completed registration form to: