QR '96 REGISTRATION FORM
First name:
Surname:
Mailing address:
Phone:
Fax:
Email:
Accommodation
[ ] Shared bedroom (total: $108 x 4 nights = $432)
I am sharing the bedroom with _____________________________.
If you do not specify a room mate, please tell us your gender.
We will try to match you up with another participant.
I am M / F.
[ ] Private bedroom. (total: $124.20 x 4 nights = $496.80)
Please specify any special dietary needs:
Payment
(including lodging and registration)
If you choose to share a bedroom, your total is $582.
If you choose a private bedroom, your total is $646.80
Checks must be in US dollars, payable to "Qualitative Workshop '96",
and mailed to:
Ms. Grace Smith
Knowledge Systems Laboratory
Gates Computer Science Bldg. 2A
m/c 9020
Stanford University
Stanford, CA 94305
USA
Sorry we cannot accept credit card payment.