DARS 2000 -- Registration Form

5th International Symposium on
Distributed Autonomous Robotic Systems

DARS 2000 Registration Form

Please complete all sections of this form. Print the form and send with your payment for the Total Amount to the DARS Conference Secretary at:
DARS 2000 Conference Secretary
Oak Ridge National Laboratory
Center for Engineering Science Advanced Research
P.O. Box 2008
Oak Ridge, TN 37831-6355
USA
.
A separate Registration Form must be completed by each participant.
Early registration is effective only if this form, complete with full payment, is received by the DARS 2000 Conference Secretary by May 31, 2000. (Faxed registrations will be accepted, to meet the early registration deadline. Fax: +1-865-574-0405)
Note that authors are required to submit early registration. The papers of authors that do not pre-register will not be included in the symposium proceedings.
Refunds will not be given for cancellations. However, substitutions can be made.
Please note that the name and address provided on this form will be included in a List of Delegates and distributed to all delegates.
The conference banquet is included in the registration fee except for student registration. Other items included in the registration fee are: proceedings, reception, 3 lunches, and coffee breaks. Extra banquet tickets can be ordered.

**Personal Details**
Title: Prof / Assoc Prof / Dr / Mr / Mrs / Ms (please circle)
Full Name:
Preferred First Name:
Affiliation:
Street:
City:	State:
Postcode:	Country:
Phone (Work):	Fax:
E-mail:	URL:
Any dietary restrictions? (Please specify):

**Registration Fee** *
(Note: all figures are in U.S. Dollars)
Category	Early Registration (by May 31, 2000)	After May 31, 2000	On-Site (i.e., after Sept. 30)	Amount
Member ** Society: _______________ Member No: ____________	$300	$360	$385	US$
Non-Member	$400	$460	$485	US$
Student ***	$200	$250	$275	US$
Extra banquet tickets Number requested: ___________	$30	$30	$30	US$
.
TOTAL AMOUNT				US$

Please enter the TOTAL AMOUNT in the Method of Payment Section (below).
*    No refunds will be given for cancellations, however substitutions will be accepted.
**  I.e., member of any of the co-sponsoring societies -- IEEE, RSJ, JSME, or SICE
***   Students must include verification of their full-time student status. Conference banquet is not included in the student registration fee.

**Method of Payment**
___ CHECK	I have enclosed herewith a check for the TOTAL AMOUNT,made out to DARS 2000.
___ CREDIT CARD	MAIL ORDER FORM: Please charge US $_____________ (TOTAL AMOUNT) to my: ____ Visa; ____ Mastercard (only Visa and Mastercard accepted) Card No: _______________________________________ Cardholder's Name: __________________________ Expiration Date: __/__ Cardholder's Signature: _______________________________ Date: __/__/__
___ ON-SITE	I will pay the ON-SITE Registration fee at the Conference (Not permitted for authors)

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