SMPC Registration Form

1. Under the "File" menu of your web browser, select "Save As"
2. In the "Save As" dialog box, there will be a "Save as type" or "Format" label. Select "text *.txt".
3. Enter a file name, and hit "OK" or "Enter" to save the form on your local hard drive

• print the form on your printer, fill in the form by hand, and mail it to the following address:
  
  Connie Van Rheenen, SMPC Conference Registrar
  MIT Media Laboratory, Room E15-401
  20 Ames Street
  Cambridge, MA 02139
  
  
• copy the form into your email editor, fill in the form, and email it to cvr@media.mit.edu

Affiliation:___________________________________________
(as you wish them to appear on your badge)

Mailing address:_______________________________________
___________________________________________________
___________________________________________________

Telephone: _____________________FAX: ________________

e-mail: _____________________

A banquet will be held on Saturday, August 2, 6:30-10:00 pm.
Do you plan to attend? Yes ____ No ____

Any dietary restrictions?________________________________.

I would like to reserve a dorm room. (Please check one of the following):
single $38 per night, no A/C ___
single $42 per night, with A/C ___
double $58 per night, no A/C ___

Important: Dorm room reservations must be accompanied with a check payable to M.I.T., mailed with your registration.