Events 

NDSS Symposium 1997

Registration Information

Registration Includes

• Attendance
• Symposium Proceedings
• Two luncheons
• Reception
• Banquet
• Coffee Breaks

* Non-Member fee includes one year Internet Society membership.

For More Information

Contact Carol Gray at the Internet Society at +1-703-648-9888 or send E-mail to Ndss97reg@isoc.org.

Web Page

Additional information about the symposium and San Diego, plus on-line registration, are available via the Web at:

http://www.isoc.org/conferences/ndss97

Sponsorship Opportunities Available!

Contact Torryn Brazell at the Internet Society at +1-703-648-9888 or send E-mail to Ndss97reg@isoc.org.

Registration Form

INTERNET SOCIETY SYMPOSIUM ON NETWORK AND DISTRIBUTED SYSTEM SECURITY
10-11 FEBRUARY, 1997                       SAN DIEGO, CALIFORNIA, USA

Fill out this form and FAX it to NDSS'97 Registration at +1-703-648-9887,
send it via E-mail to Ndss97reg@isoc.org, or mail it to NDSS97,
12020 Sunrise Valley Drive, Suite 210, Reston, VA, 20191, USA

PERSONAL INFORMATION

  __Mr __Ms __Mrs __Dr __Prof __M __Prof Dr __Dip Ing __Ing __Miss __Mlle

  First Name: ________________________________  MI: ____________________

  Family Name: ___________________________________  __Sr __Jr __II __III

  Badge Name: __________________________________________________________
  Please enter your name as you would like it to appear on your name tag.

CONTACT INFORMATION

  Title: _______________________________________________________________

  Organization: ________________________________________________________

  Street address: ______________________________________________________

  ______________________________________________________________________

  City: ________________________________________________________________

  State/Province: ___________________________  Postal Code: ____________

  Country: _____________________________________________________________

  Telephone Number (work): _____________________________________________

  Telephone Number (home): _____________________________________________

  Fax Number: __________________________________________________________

  E-mail address: ______________________________________________________

SPECIAL NEEDS?  (Vegetarian meals, wheelchair access, etc?)

  ______________________________________________________________________

  ______________________________________________________________________

APPEAR ON REGISTRANTS LIST?

  ___  Please check here if you would NOT like your name included 
       in the list of registrants.

PAYMENT INFORMATION

  All Payments must be in United States Dollars.

  Conference Fee
  --------------

  If you are an Internet Society member, you are eligible for a
  reduced conference registration fee.  Non-member symposium 
  attendees will receive a one year Internet Society membership 
  as part of the non-member registration fees.

  Check one:                        On/Before        After
                                    January 22    January 22
                                    ----------    ----------
  ___ Internet Society Member Fee   US$ 305.00    US$ 375.00

  ___ Non-Member Fee                US$ 345.00    US$ 415.00

  Method of Payment
  -----------------

  Payment must be received on/before February 7, 1997 or we will 
  be unable to pre-register you.

  1. ___ Check.  Make payable to the Internet Society.  

  2. ___ Credit Card. ___ American Express ___ Visa ___ Mastercard

         Name on Credit Card: ____________________________________
  
         Credit Card Number: _____________________________________

         Expiration Date: ________________________________________

  3. ___ CyberCash.  Account Number: _____________________________

  4. ___ First Virtual.  Account Number: _________________________

  5. ___ Wire Transfer*		

         Bank ABA Number: 054000030
         Account Number: Internet Society 148 387 10

         Riggs National Bank of Virginia   
         950 Herndon Parkway               
         Herndon, VA  20171  USA

         Wire Transfer Confirmation Number: ______________________

         * Please process wire transfer before sending registration 
	   form.

  6. ___ U.S. Government Purchase Order*

         P.O. Number: ____________________________________________

         * Please fax or mail a copy of your purchase order along 
	   with your registration form.

  Cancellation Policy
  -------------------

  Refunds (less a $25 processing fee) will be issued for cancellations 
  received on/before February 7, 1997.  No refunds will be issued 
  after February 7, 1997.

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