47th PA Convention

Online Registration Form

[JavaScript must be enabled. Optimized for Internet Explorer, form does not calculate on Netscape.]
 

 

 Please fill in:

Name*:

 Title (for ID-Badge):
Affiliation:
Address*:
City*:

ZIP-Code & Country*:
E-mail*:

    Phone (day/night):

 

The * indicates required fields.

  

 Registration Fees:
   Please check one:

 Full convention* Per single full day
 (PA Member is pre-selected)     USD     EUR     USD

      EUR

  PA Member, Associate, Affiliate  171  138  45   37
  Student**  132  109  35   30
  Non-Member  204  165  55   45
  Senior Citizen***  154  127  43   35
  Spouse/child of PA Member  132  109  35   30

  *)   Full convention:
        The 'Early Bird Discount' period elapsed July 15th, 2004. Now the above prices apply.
 **)  Please supply copy of ID
***) Including senior PA Members

      If per day, check days attending:

 

 5th Aug  6th Aug  7th Aug  8th Aug

 Banquet:

  Sat, Aug 7th, 7:00 PM
 USD 58  /  48 EUR  
per person

  (Advance Registration required)


     

 << Select total Number of Person(s)
       attending

If Vegetarian, please check

 




Note:                               
If you are bringing guests to the
 banquet, please supply name
for a courtesy nametag  >>:

 

 Convention Proceedings:
      For the first time the proceedings will be available as binaries, too.
     You have the choice between the traditional printed book,
     a CD-ROM, or both.   

      Please check:

  
 Pick-up at convention
  
    USD  /  EUR 		 
 Mailed within USA
  
    USD  /  EUR 		  
 Mailed outside USA (surface)
  
   USD  /  EUR
  Book  30  /  25  35  /  29  40  /  33
  CD-ROM  30  /  25  35  /  29  40  /  33
  Both  55  /  45  65  /  54  75  /  62

Total: USD EUR

Any additional
 message: