CONFERENCE REGISTRATION

At least one of the authors for each paper is required to register by May 25, 2005

Registration covers ONE paper ONLY. ADDITIONAL PAPERS are Can.$200/US $165 EACH

First (given) Name:			Last (family/surname) Name:
Title or Position:			Organization Name:
Address:
City	Province/State			Country		Postal Code
Phone:		Fax:			e-mail:
Guest Name:

I am a paper author - paper number(s) ______________________________ (Author must supply this information)

paper presenter - paper number(s) ______________________________ (Author must supply this information)

•		REGISTRATION			Before July 7				After July 7
	IEEE Member (Membership #_____________)			Can $400 or US $330 Can $450 or US $375 Can $200 or US $165				Can $500 or US $420 Can $550 or US $460 Can $250 or US $210		Can $ US $
	Non-IEEE Member									Can $ US $
	Student Registration Fee									Can $ US $
	Registration fee for additional paper(s)		Number of papers			_____	@ Can $200 or US $165				Can $ US $

Above fee includes welcome reception, lunches, coffee breaks, banquet and proceedings (CD only)

• OTHER OPTIONS

Extra Banquet ticket @ Canadian $90 or US $75	Can $ US $
Extra Conference Proceedings @ Canadian $90 or US $75	Can $ US $
TOTAL ENCLOSED (Make cheques payable to : IEEE PACRIM'05)	Can $ US $

Payment enclosed. Check or Money order made out to IEEE PACRIM'05 (Canadian Dollars, drawn on a Canadian bank). (Note: we CANNOT accept bank or wire transfers)

Charge to my: VISA MasterCard AMEX

Card Number		Expiration Date (Mon/Year)
Signature	Date

Please Mail or Fax to:

IEEE PACRIM'05 Attn. Ms. Catherine Chang Dept. of Electrical & Computer Eng. University of Victoria, P.O. Box 3055 Victoria, B.C., Canada V8W 3P6

Tel: 250 721 8924 Fax: 250 721 6048 Email: cathy@ece.uvic.ca