IEEE COMPUTER SOCIETY ANNUAL SYMPOSIUM ON VLSI (ISVLSI)
                        February 20-21, 2003
                           Tampa, Florida


                          Registration Form



    Name: ______________________________________________________
          (First)                    (Last)

    Affiliation: __________________________________________________

    Mailing Address:_____________________________________________
 
                    _____________________________________________
 
    Work Phone: ________________________________________________

    Email Address: ______________________________________________
 
    IEEE Number: ________________________________________________

    Registration Amount (Check one):
                                 IEEE Member Non-Member     Student
      Early Registration:         (_) $400   (_) $500        (_) $280
      Late Registration:          (_) $475   (_) $600        (_) $330
 
      * Early registration ends on January 23, 2003.
      * There should be at least one full registration (student register 
        is not sufficient) for every accepted paper. 
      * Note that we accept ONLY CHECKS payable at a Bank in United States. Credit card 
        payments are NOT accepted.
      * make checks payable to ISVLSI 2003

    Any Special Dietary Requirements:
 
    ____________________________________________________________
 
    Approximate Arrival Date: ____________________________________
 
    Approximate Departure Date: _________________________________

    Signature: _______________________  Date: _____________________


    Please mail this registration form to the Treasurer:

     Abdel Ejnioui
     University of Central Florida
     School of Electrical Engineering and Computer Science
     4000 Central Florida Blvd
     Orlando, Florida 32816-2450
     U.S.A
     Phone: 407.823.4757
     Fax  : 407.823.5835