REGISTRATION FOR ACM SIGCOMM '96 Name: Affiliation: Address: City/State/PostCode: Country (if not US): Telephone: FAX: Email: ACM Member #:* *You must list your member number in order to qualify for the member rate. To join ACM and/or SIGCOMM for the lower conference rate (the member rate plus ACM membership is less than the non-member rate) contact ACM at: Phone: 1-800-342-6626 or +1-212-626-0500, FAX: +1-212-944-1318, Email: acmhelp@acm.org (please mark your mes- sage ``SIGCOMM'96 Join''). Special Needs? (Please Specify) May we include your address and e-mail on the attendee list? [ ] Yes [ ] No REGISTRATION FEES: CONFERENCE: Early Late Early Late Early Late Member Member Nonmember Nonmember Student Student By Aug 1 After By Aug 1 After By Aug 1 After Aug 1 Aug 1 Aug 1 $325 $375 $425 $475 $110 $140 SUBTOTAL: $____________ TUTORIALS: (Please note: You must pay for each tutorial you register for) Early Late Early Late Early Late Member Member Nonmember Nonmember Student Student By Aug 1 After By Aug 1 After By Aug 1 After Aug 1 Aug 1 Aug 1 $250 $300 $350 $400 $140 $150 **Please do NOT use this form for Cable TV tutorial registration.** Monday August 26 Tutorial (choose one) Tutorial MON1: $____________ Tutorial MON2: $____________ Tuesday August 27 Tutorial (choose one) Tutorial TUE1: $_____________ Tutorial TUE2: $_____________ Additional Social Event tickets [ ] @$60 ea. $_____________ TOTAL (Conference and Tutorial): $_____________ Payment Information Credit Card Type: [ ] VISA [ ] MASTER CARD [ ] AMERICAN EXPRESS Credit Card Number: Expiration Date: / Cardholder Name: Signature: Your credit card statement will show SIGCOMM '96 charges from Danielli & O'Keefe Tradeshows. Please Note: Purchase orders cannot be accepted. Mail, FAX or E-Mail This Form To: SIGCOMM '96 Registration c/o Danieli & O'Keefe 490 Boston Post Road Sudbury MA 01776 Fax: +1-508-443-4715 Tel: +1-508-443-3330, ext. 1230 email: Reg.DOK@notes.compuserve.com