Please Fax or Mail This form to Conference Registration

1. REGISTRATION INFORMATION*:

First Name________________________Last Name_____________________
Title/Position_____________________________________
Company/Affiliation_____________________________________

Work Phone__________________FAX____________________
Email_____________________________________

Street Address_____________________________________
City__________________________State_________________Zip Code__________

Country___________________County/Province____________________________

2. REGISTRATION FEES:

Member No. _________
___ IEEE Members (By 7/31/96)			$295
___ IEEE Members (After 7/31/96)		$345
___ Non-members (By 7/31/96)			$345
___ Non-members (After 7/31/96)			$395
___ Full-time Students				$120
___ Each Tutorial Session   No.____ x $100	$___
___ Additional Proceedings copy 		$ 45

US Dollars    			Total		_____

3. DISABILITY/DIETARY NEEDS?
Disability accommodations will be provide upon request.
Call Connie at 800/262-0015.
___ I request vegetarian meals

4. METHOD OF PAYMENT:
___ Visa ___ MasterCard   ___ Discover  ___ Check (Payable to Iowa
State University)
Cardholder Name ___________________________
Signature _____________________________
Expiration Date: Mo ___   Yr ___
Card Number___________________________________

5. AIRPORT SHUTTLE:
___ I would like airport shuttle service to Ames
Arrival Date/Time __________________________
Airline/Flight No. ____________________________
(If you don't have flight information at time of registration, call
Connieat 800/262-0015 when you know.)

6. TUTORIAL SESSIONS
Check session(s) you plan to attend.

Morning Sessions
___ Multimedia: Concepts, Technical Challenges, and Implementation
___ Low Power Design Methods

Afternoon Sessions
___ Integrated Circuit Broadbanding
___ Design for Test of Analog and Mixed-Signal Circuits

Full Day Sessions
___ Introduction to Computer System Security and Technology
___ Multimedia Video-conferencing Standards Developments

7. MAIL OR FAX:
Please mail the completed form with fee to:

Marwan Hassoun
General Chair
Attn:  Registration
Iowa State University
Extended and Continuing Education
102 Scheman Building
Ames, Iowa 50011-1112
or
FAX to 515/294-6223
and include credit card information.

*  Iowa State University requests this information for the purpose of
preregistering you in a conference.  No one outside the university,
with the exception of participants in this conference, is routinely
provided this information.  If you fail to provide the required
information, we cannot promise accurate registration. (Reference: Iowa
Code, Chapter 22.11; Iowa Fair Information Practices Act.)