SCIENCE INFORMATION SYSTEMS INTEROPERABILITY CONFERENCE (SISIC)

University of Maryland, University College Conference Center

November 6-9, 1995

REGISTRATION FORM

GENERAL INFORMATION

The registration desk will be open in the main concourse in the Conference Center by the Auditorium from 6:00 p.m. to 9:00 p.m. on November 5, 1995 as well as on the regular days of the conference.

The early registration fee for regular participants will be $ 200.00. The fee for registration after October 27, 1995 will be $ 225.00.

INSTRUCTIONS:

Please complete this form, retain a copy for your records, and RETURN IT BEFORE OCTOBER 27, 1995. The registration fee before that date will be $200. After that date the fee will be $225. To register more than one person as a participant, please use one copy of this form for each person.

Send all remittances in US dollars to:

Jorge Scientific Corporation
7500 Greenway Center Drive
Suite 1130
Greenbelt, Maryland 20770
USA

Note: Credit cards will be accepted for registration but the registration form with signature and credit card numbers should be mailed or faxed (FAX 301-220-1704) to Jorge Scientific.

Please provide the following information:

Name    ___________________________________________________________

Name for badge ____________________________________________________

Affiliation    ____________________________________________________

Mailing Address ___________________________________________________

                ___________________________________________________

                ___________________________________________________

                ___________________________________________________


Telephone Number __________________________________________________

Fax Number_________________________________________________________

E-Mail address_____________________________________________________



REGISTRATION FEE
                             
$200.00 on or before October 27, 1995       
$225.00 after October 27, 1995                    
                                         

SOCIAL ACTIVITIES

____  I will attend the free Welcome Reception at the University of Maryland 
          Conference Center on Sunday, November 5  (6:00-9:00)

____  I will attend the Group Dinner at the Newton White Mansion on Tuesday,
          November 7 at a cost of $ 25 per person, payable now or during the
          registration at the workshop.  I will need ________ ticket/s.


METHOD OF PAYMENT

My 
________ check
________ money order
________ purchase order
for $__________  made payable to Jorge Scientific is 
_______ included  
_______ will be sent as soon as possible

  
I wish to pay the total of $__________ by credit card.  

Credit Card Type (Visa/MasterCard/etc.)  _________________________________

Credit Card No. __________________________________________________________

Expiration Date  _________________________________________________________

Signature ________________________________________________________________ 



______ I will pay the amount of $ ______  at the conference.

Return to SISIC Home Page

For general questions about the Science Information Systems Interoperability Conference contact:
Ms. Sandie Jones, sjones@pop200.gsfc.nasa.gov, (301) 220-1701, FAX (301) 220-1704
Jorge Scientific Corporation
7500 Greenway Center Drive
Suite 1130
Greenbelt, MD 20770

For program-related or technical questions about the Science Information Systems Interoperability Conference contact :
Dr. James Thieman, thieman@nssdca.gsfc.nasa.gov, (301)286-9790
National Space Science Data Center, Code 633.2
NASA/Goddard Space Flight Center, Greenbelt, MD 20771