LUATCS '99     REGISTRATION FORM
   ==========     =================

Wherever requested to indicate choices, please mark with an X in the
brackets or leave blank. The completed registration form should reach
us by SEPTEMBER 1 per e-mail, fax, or ordinary mail.

1. PERSONAL INFORMATION
Title, surname, and first name(s):.....................................
Affiliation:...........................................................
Address:...............................................................
.......................................................................
Telephone:.............
Fax:...................
E-mail address:................................

Student[ ]   Academic[ ]  Other[ ]  (Please choose one of these.)

Accompanying persons:     Yes[ ] / No[ ]
If yes: Name(s):..............................................

2. DETAILS ON PARTICIPATION
2.i) Which parts of the school would you like to attend?        
        Part 1 [ ]              Part 2 [ ]              Both parts [ ]

2.ii) Which courses and tutorials/workshops do you intend to attend? 
(This is just preliminary info for us. You can change your mind later.)

Part 1 (1-4 Dec): 
Blackburn[ ]                    Gumm[ ]                 Melton[ ]
Schlingloff[ ]                  Valeriote[ ]            Venema[ ]

Part 2 (6-10 Dec):   
Chaochen[ ]                     Davey[ ]                Dawar[ ]
de Rijke[ ]                     Farley[ ]               Gehrke[ ]
Hirsch[ ]                       Hodges[ ]               Jacobs/Rutten[ ]
Jech[ ]                         van Benthem[ ]
Vardi[ ]                        Zucker[ ]

2.iii) Which sets of course notes/readers do you want to receive? 
(The cost of 6 sets per part is included in the registration fee; 
the rest will cost up to R20 per set - payable on arrival.)

Part 1 (1-4 Dec): 
Blackburn[ ]                    Gumm[ ]                 Melton[ ]
Schlingloff[ ]                  Valeriote[ ]            Venema[ ]

Part 2 (6-10 Dec): 
Chaochen[ ]                     Davey[ ]                Dawar[ ]
de Rijke[ ]                     Farley[ ]               Gehrke[ ]
Hirsch[ ]                       Hodges[ ]               Jacobs/Rutten[ ]
Jech[ ]                         van Benthem[ ]  
Vardi[ ]                        Zucker[ ]



2.iv) Do you intend to give a talk in a workshop or an open session? 
              Workshop[ ] / Open session[ ] / None [ ] 

If yes, please give a title and specify the workshop (if applicable):
.................................................................
3.  TRAVEL
3.i) Arrival date and time, airline and flight number (if already known):
     ............................................................
3.ii) Departure date and time:...................................

Do you need transportation from and to Johannesburg bus station or
airport? Station[ ] / Airport[ ]

4.  ACCOMMODATION (If you have accompanying persons, please book for
                   them, too.)
4.i) Part 1: December 1-4. 
Arrival and registration day: Nov 30. Departure: Dec 5. 

RAU Island: total package of R550 per person, including accommodation,
3 meals a day, refreshments, and bus/boat transport to and from the
island.

4.ii) Part 2: Dec 6-10, RAU Campus. Arrival and registration day: Dec 5. 
      Departure: evening of Dec 10, or later; 
      for the hostels: not later than Dec 11 unless arranged individually.  

Please indicate your preferences for accommodation in a priority
order, choosing from the options below. All prices are per room per
night, for single rooms including breakfast, for double rooms
excluding breakfast (@R29 per person).

1:
2:
3:

If sharing a double room in the hotel, the name of your roommate:

Note that a R200 accommodation deposit is required, payable with
registration fee.

A) Hotel                SINGLE                  DOUBLE 
                        R244                    R230

B1) Guest-house  at R200 - R250.
B2) Guest-house  at R250 - R300.

C) Student hostel: R100.

D) My own arrangement. 

5. VARIA.  If you have accompanying persons, please book for them as
well, by putting a number in the brackets. All payments are due on
arrival.

5.i) Would you like lunch package(s) during Dec 6-10 (@ R150 per
package)? Yes [ ] No[ ].

Please specify any dietary restrictions:

5.ii) Would you like to attend the banquet on Dec 8 (@ R70 per
person)? Yes [ ] No [ ].

5.iii) Would you like to join the outing on Saturday, Dec 11 (@ approx. R50)?
- to Gold Reef City, Johannesburg [  ] 
- to the Rhino and Lion Nature Reserve and Sterkfontein Caves [  ].


6. PAYMENTS. 
6.i) Please indicate the registration fee applicable to you (IF
PAYABLE AFTER SEPTEMBER 1, PLEASE ADD 20% TO THE RATES BELOW) here: [ ]

Part 1          Part 2          Both

*Student                        R100            R100            R200
Academic                        R200            R200            R400
Accomp. person                   R50             R50            R100
Other                           R300            R300            R600

*Please attach proof.

TOTAL PAYMENT DUE: (Deposit and registration fee) [       ]


6.ii) MEANS OF PAYMENT.

A) Personal or bank cheque PAYABLE IN SOUTH AFRICAN RANDS, made out
to: RAU LUATCS '99.
Send to: LUATCS'99, Department of Mathematics, PO Box 524, Auckland
Park 2006, SOUTH AFRICA.

   Cheque enclosed :  Yes[ ] / Will be sent later [ ].

B) Please debit my credit card:
   Card type: Visa[ ]   Master[ ]  Euro[ ]  
              American Express[ ]  Diners Club [ ]
   Card number :                          Expiry date :
   Name as it appears on the card:
   Authorisation for total amount:

C) Bank Transfer To: ABSA Bank, Auckland Park, Branch number 33510524,  
Account number : 284 0000 136. 

PLEASE NOTE: if you use bank transfer, your surname and initials as
well as this reference number: 9331 8659 05 MUST APPEAR on the deposit
slip, of which a copy must be sent to us.


7) REMARKS (if any):






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