Multimedia 97 Please type or print clearly. Use only one two-sided form for each registrant. Photocopy additional forms if necessary. Full Name: Title: Organization/Affiliation: Address: Dept. or M/S: City: State/Province: Zip/Postal Code: Country: E-mail: Telephone: Fax: ACM or SIGMM Member #: You must fill in your member number to qualify for member rates Conference only: Does not include courses. Your conference registration includes print proceedings, admission to all conference sessions, and evening function on Tuesday. Member (by 10/18/97): $395 Member (after 10/18/97): $515 Non-Member (by 10/18/97): $525 Non- Member (after 10/18/97): $625 Student (student ID required) (by 10/18/97): $185 Student (student ID required) (after 10/18/97): $255 Conference registration: $____________ Courses only: Does not include conference. You must indicate course selections on the reverse side of this form. One half-day course: Member (by 10/18/97): $265 Member (after 10/18/97): $310 Non-Member (by 10/18/97): $290 Non-Member (after 10/18/97): $335 Multiple half-day courses: Note that a full-day course counts as two half-day courses. Member (by 10/18/97): $220 Member (after 10/18/97): $255 Non-Member (by 10/18/97): $240 Non-Member (after 10/18/97): $275 Number of half-day courses _______ x Price = $_________ Total amount enclosed: $______________ General Information For up-to-date information about ACM Multimedia '97 refer to the World-Wide Web page: http://www.acm.org/sigmm/MM97 or contact: Judy Osteller ACM 1515 Broadway, 17th Floor New York, NY 10036 Phone: +1-212-626-0605 Fax: +1-212-302-5826 E-mail: osteller@acm.org Payment Options: Mail this form with payment to Multimedia '97 c/o Nth Degree 490 Boston Post Rd. Sudbury, MA 01776 USA or fax, with credit card information, to +1-978-440-8931. Forms will not be processed without full payment. Make checks payable to Multimedia '97 or fill in your credit card information below. Please note: the charge will be billed under Nth Degree. Multimedia '97 will not accept P.O.s. _______ AMEX _______ MC/VISA Card Number: Exp. Date: Name as it appears on card: Cardholder's signature: Cancellation policy: Confirmed registrants who cannot attend are entitled to a refund of paid fees less a $50 processing fee if a written request is received by us on or before October 18. After October 18, there are no refunds. Substitutions are welcome. (For more information call 800-524-1851x1226 (in USA or Canada only) or 978-443-3330 x1226.)