Registration for Mobicom '96


_______________________________________________________________
Name

_______________________________________________________________
Company/Organization 

_______________________________________________________________
Address

_______________________________________________________________


Telephone Number_______________________FAX_____________________


URL(WWW) Address_______________________Email___________________


_______________________________________________________________
Name on Badge

ACM Membership #:______________________________________________
                        (required for ACM member rate)
 

If you are not currently an ACM member, you may join ACM now to take full 
advantage of discounted rates. Mention ``new member" when you send this form 
and your payment to the registration chair. Send your membership dues directly 
to ACM at: Phone 1-800-342-6626 or +1-212-626-0500, FAX: +1-212-944-1318, 
Email: acmhelp@acm.org, http://www.acm.org/sigmobile/membership.html. 


Exclude my address from:
         MobiCom Email list ___  Attendee Lists ____    

Conference Fees:
----------------

Tutorials (Check each tutorial attending)

Morning Session, 8:30 A.M. - 12:30 P.M. (choose one)
[] T1 Disconnected Browsing : WWW & Mobile Computing    
[] T2 Air Interface Standards 

Afternoon Session, 1:30 P.M. - 5:30 P.M. (choose one)
[] T3 Secure Mobile Communications 
[] T4 Mobile Networking within the IETF
              


                Early Registration      Late Registration
                Before  10/18/96        After 10/18/96
                     
Fee for each Tutorial

ACM Members:            $180____        $225____
Non-members:            $220____        $265____
Full-time students:     $100____        $125____ 

Total fee for Tutorials ________        _______

Conference Registration* 

ACM Members:            $320____        $370____
Non-members:            $400____        $450____
Full-time students#:    $125____        $155____ 


Extra Dinner Banquet:   $55_____        $55_____
Extra Proceedings:      $45_____        $45_____


*includes proceedings, sessions, reception, lunches and banquet
#includes proceedings, sessions, reception and lunches 

Total Fees              $________       $_________
 

Vegetarian Meals:       Yes _____       No _______


___________________________________________________________
  Special needs: (Please describe)

Payment Method:
---------------

[] Check or money order payable to Mobicom '96

[] VISA         [] Mastercard (Only VISA or Mastercard, please)

Credit Card Number:____________________________

Exp. Date:_____________________________________

Card holder Name:_______________________________
               (Exactly as printed on the card)     



Please complete and return with check, credit card info or money order 
(no purchase order) to : 

Attn: MobiCom '96 
Pravin Bhagwat 			           Credit card payments also 
T.J. Watson Research Center 		        accepted via: 
P.O. Box 704 				   Fax: +1 914-784-6025 
Yorktown Heights, NY 10598, USA 	   Email: pravin@watson.ibm.com