UAI95 Registration Form

Family name: 			First name:
Title:       			Organization: 
Address:     			City:  
State:       			Country:
Zip Code:    			Phone:
Fax:         			E-mail:


Registration Fees

[ ] Regular: Before July 1st, 1995     $200
[ ] Regular: After July 1st, 1995      $240
[ ] Student: Before July 1st, 1995     $100
[ ] Student: After July 1st, 1995      $120

Students should attach a letter from their supervisor or institution
confirming their student status (an email message to
poole@cs.ubc.ca from the supervisor is OK).

A Welcome dinner on Friday night is included in the registration fee.
If you would like to bring a guest the cost is $45 per person.
How many guests will you be bringing? 
                     
Payment

[ ] Visa 
[ ] MasterCard 
[ ] American Express 
Card Number:
Expiry date:
Note that you must bring your credit card to the conference.
[ ] Cheque to "Association to Uncertainty in Artificial Intelligence".
    The participant's name should be mentioned on the cheque.

Payment of the registration fee should be made in US Dollars.

We will put all information about the conference online, and cannot
issue receipts for credit cards until the conference.  Do you still
need hard-copy confirmation of registration before the conference?