Second IEEE International Symposium on Object-oriented Real-Time Distributed Computing 3rd.-5th. May 1999, Saint Malo, France REGISTRATION FORM [] Mr [] Mrs [] Miss LAST NAME: ___________________________First Name:______________________________ Organization: _________________________________________________________________ Address: ______________________________________________________________________ _______________________________________________________________________________ Town: _________________________________________________________________________ Zip Code: ______________________Country: ______________________________________ Tel: ___________________________Fax: __________________________________________ E-mail: _______________________________________________________________________ will participate to the Second IEEE International Symposium on Object-oriented Real-Time Distributed Computing_ PAYEMENT All prices in French Francs (FRF), 20,6% VAT included Early registration fee (deadline 10 April 1999): IEEE members(*): [] (2300 FRF) non-members: [] (2600 FRF) Late registration fee (11 April 1999 and after): IEEE members(*): [] (2700 FRF) non-members: [] (3000 FRF) (*)IEEE membership number: __________ These fees include the symposium proceedings, access to the meeting rooms, 3 lunches and banquet and coffee breaks_ All payments (in French Francs) will be made: [] by cheque to "Agent comptable de l'INRIA", sent by post [] by bank transfer to: Trésorerie Générale des Yvelines, Versailles: (bank code 10071; branch code 78000; account number 00003003958; key 80) [] by credit card: For this mean of payment, the original signature is mandatory Cardholder name and first name: _____________________________________________ Card number: |_|_|_|_| |_|_|_|_| |_|_|_|_| |_|_|_|_| Expiry date: |_|_| |_|_| I hereby authorize INRIA to charge my credit card: [] Visa [] Mastercard [] Eurocard Cardholder signature ______________________ | | | | |______________________| Please write your name clearly and make reference to the Second IEEE International Symposium on Object-oriented Real-Time Distributed Computing on your payment. Registration without payment will not be considered. CANCELLATION Fees will be returned in full for any written cancellation before May 1st., 1999. No refund will be made in respect of cancellation received after this date. DIETARY RESTRICTIONS: _______ DATE: _______________________ SIGNATURE: __________________