| Name* | |
| E-mail address* | |
| Phone # | |
| Street Address* | |
| Country* | |
| Affiliation* | |
| Dates of planned attendance* |
| Postmarked
on or before March 1, 2013:
SIAM or AWM Member (early) $405.00
| Postmarked
after March 1, 2013:
SIAM or AWM Member $450.00
|
| YES NO |
| Female Male |
| Check or money order | Checks written to: Copper Mtn. Conference. Must be in U.S. Funds on a U.S. bank. If paying with a EuroCheque, please add $6 to your fee for bank processing. |
| Credit Card ONLINE (VeriSign/PayPal) | (Visa or MasterCard only) |
|
Credit Card, sending information             via phone or snail mail | (Visa or MasterCard only) Please call or mail Front Range Scientific Computations. |
       
| We have a bulletin board so you can leave messages about sharing rooms at Copper Mountain. The theory is that you can use this system to post your needs and questions about room-sharing so that other attendees can respond. We take no responsibility concerning the contents of any message on the bulletin board. In addition, the bulletin board may be cleared out without notice. |