# LCPC 2000 Registration Form
# Please fill in this form and email it to smidkiff@us.ibm.com
# Please send your check (US funds, $225 early registration, $275 late)
# separately via mail.  The check should be made out to IBM/LCPC 2000.
# Do not edit the file unnecessarily, as it will be automatically processed.

# Your name and affiliation, as you wish it to appear on your name badge
# Name:
# Affiliation:

# Your address information
# Address 1:
# Address 2:
# Address 3: 
# Address 4:
# Address 5:

# email address: 

# (optional) phone number:

# In the following, remove that which is not your answer.

# Include my email address in the proceedings? yes no

# Do you have any special dietary requirements other than vegetarian food? yes no