HLDVT'97 WORKSHOP REGISTRATION FORM

Mail or fax this form to:

HLDVT'97
5305 Spine Rd., Ste. A
Boulder, CO 80301 USA
Tel: 303 530 4562
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 10, 1997)

IEEE Member              IEEE Student Member       Non-Member
   $295                         $150                  $395

LATE REGISTRATION
(After October 10, 1997)

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. FOR PAYMENTS FROM NON-U.S. BANKS THE ATTENDEE WILL BE
BE CHARGED A COLLECTION FEE OF $30.00. PURCHASE ORDERS ARE NOT ACCEPTED.
MAKE CHECKS PAYABLE TO 1997 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 10, 1997 will be subject
to a $50 processing fee. No refunds will be made for cancellations received
after October 10, 1997,all registration fees will be forfeited.

Attendance is limited. Register early to avoid disappointment.


HLDVT'97 HOTEL REGISTRATION FORM

REGISTER BEFORE OCTOBER 10, 1997 FOR THE HLDVT WORKSHOP ROOM RATE OF $140

Mail or fax this form to:

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

First Name _______________________     Last Name ___________________________

Company _____________________________  Mail Stop ___________________________

Street Address ___________________________________ City ____________________

State __________________ Zip Code ___________ Country ______________________

Tel: ________________________________ Fax: _________________________________

Check Accommodations Desired

Single @ $140  ____      Double @ $140 ____
Rates are per day in US$. 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.