SAC 2002 REGISTRATION FORM August 15-16, 2002, St. John's, Newfoundland, Canada Surname: _________________________ Given Name: _______________________ Organization: _________________________________________________________ Address: ______________________________________________________________ _______________________________________________________________________ ____________________________________________ Postal Code: _____________ Phone: __________________ e-mail: _____________________________________ CONFERENCE REGISTRATION: (Please check the appropriate box.) ** You must be enrolled as a full-time student to receive student rate. ** [ ] Early Registration (by July 12): $300....$________ [ ] Late Registration (after July 12): $350....$________ [ ] Early Student Registration (by July 12): $150....$________ [ ] Late Student Registration (after July 12): $200....$________ Whale watching excursion @ $42 per ticket: ( )x$42....$________ Signal Hill / Cape Spear excursion @ $12 per ticket: ( )x$12....$________ ========================================================================= TOTAL AMOUNT PAYABLE: $________ Notes: - The total amount must be paid upon registration. - A receipt will be issued for the registration amount only. Method of Payment:[ ]Credit Card [ ]Cheque in Canadian funds (payable to "Memorial University of Newfoundland") Payment by Credit card (select one): [ ]Visa [ ]Mastercard Name on Card: __________________________________________ Card Number: ___________________________ Expiry Date: _____/_____(mo/yr) Cardholder's signature: ________________________________ ************************************************************************* Is a vegetarian meal required for the banquet? YES ___ NO ___ Please indicate any other special dietary requirements: ************************************************************************* Mail or FAX this form to: Yvonne Raymond Faculty of Engineering and Applied Science Memorial University of Newfoundland St. John's, NF CANADA A1B 3X5 Fax: 709-737-3056, Phone: 709-737-7467