MobiCom 2004 The Tenth Annual International Conference on Mobile Computing and Networking September 26 - October 1, 2004 • Philadelphia, Pennsylvania, USA REGISTRATION FORM Name (first, middle, last):_______________________________________________________ First Name (for badge): __________________________________________________________ Affiliation (for badge): _________________________________________________________ Title/Job Function: ______________________________________________________________ Address: _________________________________________________________________________ City: _________________________________ State/Province: ________________________ Zip/Postal Code: ___________________ Country: ___________________________________ Email: __________________________________________________________ Phone: (____)___________________________ Fax: (_____)_____________________________ ACM/SIG Member ID: _______________________________________________________________ For Student Registration only: University:_________________________________ Student ID_________________________ Special Needs: ________________________________ Special Dietary Requirements: Vegetarian Vegan ___ Do not include me in the conference attendee list PLEASE NOTE: Tutorial registration fee includes tutorial notes of the tutorial(s) you register for. You may register for more than one tutorial; each registration fee is separate. Conference registration fee includes one copy of the conference proceedings, two Conference Lunches, Welcome Reception on September 27, and one ticket to the Conference Banquet Cruise on September 29. Workshops registration fee includes lunch on October 1 and workshop notes for the workshop you register for. REGISTRATION FEES Please circle appropriate fees. All fees are in US dollars. __________________________________________________________________________________ Registration on or before Registration after September 10, 2004 September 10, 2004 Non- Student Non- Student Member Member Member Member Member Member __AM01 - Conference $635 $700 $300 $750 $800 $325 Full Day Tutorials $375 $450 $175 $450 $510 $200 Half Day Tutorials $250 $300 $100 $325 $400 $150 Workshops (all workshops are at the same time, full day, October 1): __W1 - DIALM-POMC $170 $205 $ 95 $210 $245 $135 __W3 - MobiWac $185 $230 $160 $220 $265 $160 __W4 - VANET $ 75 $100 $ 25 $ 90 $120 $ 30 __W5 - WiSe $165 $215 $110 $215 $265 $160 __W6 - WMASH $165 $215 $140 $215 $265 $140 __________________________________________________________________________________ Member registration rates are available for members of SIGMOBILE and/or ACM. You must provide your membership number with registration. If you are not currently a member, you should consider joining, getting your membership number, and then registering to get the discount registration fees. Student registration fees are available for full-time students. You must provide your student ID number with your registration and must show proof of full-time student status, such as your student ID card, at the registration desk at the conference. Student registration includes all items in the full registration. Tutorial Choice(s) — Please mark choices below: September 26, 2004 ____ T1 -Evolution of IEEE 802.11 Wireless LANs: QoS, Security, Mobility, and Emerging Standard Perspectives (Full Day) ____ T2 -Theoretical Foundations of Wireless Networking (Half Day) September 27, 2004 ____ T3 -Power-Efficient Protocols for Wireless Ad hoc Networks (Full Day) ____ T4 - Sensor Networks: Hardware, Software, and Applications (Half Day) Extra Banquet Tickets (One ticket is included with MobiCom’04 Conference Registration Fee. Ticket availability not guaranteed for registrations received after September 10, 2004. After September 10, 2004, tickets will be distributed on first-come-first-serve basis. Extra tickets are subject to availability and sold on first-come-first-serve basis) BAN - Extra Banquet Cruise- September 29, 2004: $ 80 x ____ = _____ Total Fees: US $_________________________ (Make checks payable to ACM/MobiCom'04) Payment included (circle one): American Express Master Card Visa Check Credit Card Number: __________________________________ Expiration Date: __________________ Name as it appears on Credit Card:________________________________________________ Date: ___________________ Signature: __________________________________________ For Registration by Fax: 1-703-631-6288, Attention: ACM/MobiCom 2004 Registration Center For Registration by Mail (include check and registration form): Attention: ACM/MobiCom2004 Conference Registration Center c/o J. Spargo and Associates 11212 Waples Mill Rd. Suite 104 Fairfax, VA 22030 For questions, contact our Conference Registration Center: by mail: mobicomregistration@jspargo.com by telephone (8:30 AM – 5:00 PM EST): 1-703-449-6418 Cancellation Information: Written requests for refunds must be received by the MobiCom2004 Conference Registration Center (see address above) no later than September 1, 2004. Refunds are subject to a US $75 service charge. Registered participants who fail to attend or notify the MobiCom Registration Center of cancellation by the above date are subject to the full fee. You should receive e-mail confirmation once your order is processed. If you do not please contact our conference registration center at the above contact information.