CRYPTO 2000

August 20--24, 2000
Santa Barbara, California, USA

Registration Form

Instructions: To register for Crypto 2000, send this completed form with payment to:

Crypto 2000 Conference
Campus Conference Services
University of California
Santa Barbara, CA 93106-6120
USA

If paying by credit card, the completed form can be faxed to (805) 893-7287 . We cannot accept registration by email.

Personal Information

Name:
______________________________________________________________
Affiliation:
______________________________________________________________
Address:
______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________
Phone:
______________________________________________________________
Fax:
______________________________________________________________
Email:
______________________________________________________________
URL:
______________________________________________________________
Sex:
______________________________________________________________

Conference Registration (choose a, b, or c)

a. Full Time Student $230 [     ]
b. Attended Eurocrypt 2000 (Belgium) $440 [     ]
c. Regular Registration Fee $520 [     ]

IF YOUR REGISTRATION IS POSTED AFTER JUNE 30, 2000 - ADD $80 [     ]

Room

Room (no smoking, 4 Nights, Sun. to Thur.) and Board (breakfast and lunch Mon. to Thur.):

Single Room $250 [     ]
Double Room $193 per person
(Optional: Roommate's Name: _________________________________) 		[     ]
Saturday Night $70 per person single
$56 per person double 		[     ]
[     ]
Thursday Night $71 per person single
$57 per person double 		[     ]
[     ]

Guest

Extra Guest for Social Programme only: $140 per person [      ]

Guest's Name: ____________________________________________________

IF YOUR EXTRA GUEST FEE IS POSTED AFTER JUNE 30, 2000 - ADD $80 [      ]

Total and payment

TOTAL FUNDS DUE (US Dollars): $________________

Payment - We accept checks IN US DOLLARS DRAWN ON A US BANK made payable to "U.C. Regents", or credit cards. You MUST include your payment in full when you return this form. If you choose to pay by credit card, complete the following.

Card Type:
American Express [      ]
Visa [      ]
MasterCard [      ]
Card Number:
______________________________________________________________
Expiration Date:
______________________________________________________________
Name on Card:
______________________________________________________________
Cardholder's signature:
______________________________________________________________

IACR Membership and Privacy

When you register and pay for Crypto you will automatically become a member of IACR for next calendar year free of charge. As a member next year you will receive the IACR (email) Newsletter and The Journal of Cryptology. If you do NOT want to be a member next year, and do NOT want to receive the Journal or Newsletter, choose this box:

I DO NOT WISH TO BE AN I.A.C.R. MEMBER [      ]

Personal Information - The personal contact information that you provide is maintained in the IACR Membership Database and will be published in the conference attendee list and the IACR Membership List that is sent to all members every year. It is NOT made available to any other organisation in electronic form. If you do NOT want your contact information to be published in the conference attendee list and the IACR Membership List, choose this box:

I DO NOT WANT MY DETAILS PUBLISHED [      ]