HLDVT'96 HOTEL REGISTRATION FORM

PRINT OUT AND MAIL OR FAX IN

REGISTER BEFORE OCTOBER 15, 1996 FOR THE HLDVT WORKSHOP ROOM RATE OF $135

Mail or fax this form to:

The Claremont Resort
41 Tunnel Road,
Berkeley, CA 94705.
Tel. 1 800 551 7266
Fax: 510 549 8582
E-mail: 103145.2075@compuserve.com
URL: http:///www.claremnt.com

First Name _______________________     Last Name ___________________________

Company _____________________________  Mail Stop ___________________________

Street Address ___________________________________ City ____________________

State __________________ Zip Code ___________ Country ______________________

Tel: ________________________________ Fax: _________________________________

Check Accomodations Desired

Single @ $135  ____      Double @ $135 ____
Rates are per day in US$. Add 11% tax.

Arrival Date _____________  Departure Date ______________

Your reservation can be guaranteed by credit card. Your credit card will be
billed for first nights deposit.

Credit Card ___    Visa ___  Mastercard ___ American Express ___

Card No. _______________________________  Exp. Date ____________

Name (as it appears on card) ___________________________________

Signature _____________________________

Cancellations must be received at least 24 hours prior to arrival.

HLDVT'96 WORKSHOP REGISTRATION FORM

Mail or fax this form to:
HLDVT'96
5305 Spine Rd., Ste. A,
Boulder, CO 80301 USA.
Tel: 303 530 4333
Fax: 303 530 4334

First Name _______________________     Last Name ___________________________

Company _____________________________  Mail Stop ___________________________

Street Address ___________________________________ City ____________________

State __________________ Zip Code ___________ Country ______________________

Tel: ________________________________ Fax: _________________________________

E-mail: _________________________________ IEEE Member No.: _________________

Dietary Requirement: Vegetarian ___  Other _________________________________

ADVANCE REGISTRATION (Postmarked by October 15 1996)

IEEE Member              IEEE Student Member       Non-Member
   $330                         $150                  $410

LATE REGISTRATION (After October 15 1996)

IEEE Member              IEEE Student Member       Non-Member
   $395                         $200                  $495

Total Fees ___________

SEND FULL PAYMENT in US$ WITH THIS FORM. USE A CHECK DRAWN ON A US BANK OR
A MAJOR CREDIT CARD. PURCHASE ORDERS ARE NOT ACCEPTED. MAKE CHECKS PAYABLE
TO 1996 IEEE HIGH LEVEL DESIGN VALIDATION & TEST WORKSHOP. USE YOUR CREDIT
CARD IF REGISTERING BY FAX.

Check ___

Credit Card ___    Visa ___  Mastercard ___  American Express ___

Card No. _______________________________  Exp. Date _____________

Name (as it appears on card) ____________________________________

Signature _______________________________________________________

Refunds: Requests for refunds received before October 15, 1996 will be
subject to a $50 processing fee. No refunds will be made for
cancellations received after October 15, 1996. Attendance is
limited. Register early to avoid disappointment.

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