6th International Colloquium on Structural Information and Communication Complexity SIROCCO '99 - Lacanau, France, July 1-3, 1999 http://dept-info.labri.u-bordeaux.fr/sirocco99/ REGISTRATION FORM ___________________________________________________________________________ The conference will be held to ***Hotel-Golf L'Ardilouse at Lacanau-Ocean, situated in the pine forest. The fee covers 3 nights, (June 30, July 1 and July 2) meals and dinners, a copy of the proceedings, swimming pool, and the reception buffet. The fee must be paid before May 31, 1999. Registrations later than May 31, will be taxed of +500 FF(French Francs). Since attendance is limited (~ 50 rooms), registration will be accepted first-come first-serve. The registration fee is (before May 31, 1999): - 2.400 FF for senior, single room (double or appartment are available on request at gavoille@labri.u-bordeaux.fr) - 1.500 FF for student (a certificate will be asked), double room only Further question should be addressed to gavoille@labri.u-bordeaux.fr. To register, please fill out the following form, and email to: gavoille@labri.u-bordeaux.fr Subject: REGISTRATION or fax it to +33 5-56-84-66-69 Name: ________________________ First Name: __________________ Sex: _______ Affiliation: _______________________________________________________________ Address: ___________________________________________________________________ ____________________________________________________________________________ Phone: _______________________________ Fax: _______________________________ E-mail: ____________________________________________________________________ Did you attempt to participate to SPAA99 in St Malo? YES [ ] NO [ ] Dietary restrictions (we'll try to do our best): __________________________ Student (a certificate will be asked): YES [ ] NO [ ] Desired partner for room sharing (if student): _____________________________ To confirm your registration you can pay either by credit card (see below), or by a bank transfert to B.N.P., 471 bis, cours de la Liberation, 33400 Talence, France Name Account: ADRIB International Bank Account Number: FR76 3000 4012 1800 0100 1689 047 (Please make sure that the bank transfer is made net of all bank charges and commissions) For creadit card payment, you *must* provide the following credit card information, now: American Express: [ ] Visa: [ ] Master: [ ] Credit Card No.: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Expiration Date (mm/yy): __ __ / __ __ Name of Card Holder: (use exact spelling) ____________________________________________________________________________ Please sign (if fax): ____________________________________________________________________________