IEEE-NANO’2002

Second IEEE Conference on Nanotechnology

Washington DC, August 26-28, 2002

Tutorials on August 25, 2002

REGISTRATION FORM

If possible, please register electronically on our secure website at https://swww3.ieee.org/EventReg/?societyBrand=NANO_2002

Please complete ALL information below to ensure that your registration will process correctly.

All fields are REQUIRED. Forms received without payment WILL NOT be processed.

Please print clearly or type in the information.

FULL NAME: ________________________________________________________________________

^{(Last) (First)}

AFFILIATION: _______________________________________________________________________

ADDRESS: ___________________________________________________________________________

CITY: _________________________ STATE: ______________ POSTAL CODE: _________________

COUNTRY: ________________________________ PHONE: _________________________________

FAX: __________________________ E-MAIL: _____________________________________________

IEEE MEMBER NUMBER: _____________________________________________________________

IF YOU ARE PRESENTING A PAPER, SESSION AND PAPER #: _____________________________

In order to Advance Register, form and payment must be received by July 31, 2002.

Regular registration includes a copy of Conference Proceedings, a CDROM, ticket for banquet and ticket for reception.

Student registration includes a CDROM and ticket for reception but no Proceedings and banquet.

o Advance Registration IEEE Member @ US$450.00 $____________

o Advance Registration Non-Member @ US$560.00 $ ____________

o Advance Registration Student @ US$200.00 $_____________

o On site Registration IEEE Member @ US$520.00 $_____________

o On site Registration Non-Member @ US$650.00 $_____________

o On site Registration Student @ US$270.00 $_____________

o Tutorial Registration (Aug. 25, 2002) @ US$150.00 per tutorial

Tutorial #1____ #2____ #3____ #4____ #5____ #6____ $_____________

o Retirees and IEEE Lifemembers register at student rate $_____________

o Additional Proceedings Volume @ US$50.00 $_____________

o Additional banquet ticket, companion US$50____, student US$25____ $_____________

TOTAL AMOUNT DUE & ENCLOSED $

MAIL WITH CHECK MADE PAYABLE TO “IEEE/NANO 2002” TO:

NANO 2002 Registrar, c/o IEEE Conference Management Services

445 Hoes Lane, P.O. Box 1331, Piscataway, NJ 08855

Tel: +1 732 562 5337; Fax: +1 732 465 6447; Email: nano2002reg@ieee.org

Circle one: Visa/ MasterCard /American Express/Diners’ Club

Credit Card #: _____________________________ Expiration date: ___________________

Signature: ________________________________________________________________

Billing name and address (if different from that at the top of this form):

___________________________________________________________________________

NOTE: CANCELLATIONS OF REGISTRATION MUST BE RECEIVED IN WRITING BY JULY 31, 2002. Payments will be refunded less a $50.00 service charge. AFTER JULY 31, 2002, cancellations will be accepted but not refunded. Substitutions may be made prior to July 31, 2002.