WVLSI'99 Registration Form
    	            April 8-9, 1999, Orlando, FL, USA
_________________________________________________________________________

Registration Fees:
                       Before 3/10/99   After 3/10/99
IEEE Members              $350               $420   
Non-Members               $425               $525   
Full-time Students        $150               $200   

   - Advance registration at lower rate is accepted until
     March 10, 1999.
   - Full payment in US dollars must be sent with the registration form: 
     check drawn from a US  bank.
   - Make checks payable to IEEE CS WVLSI'99

Registration form along with payment must be mailed to

    Vijaykrishnan Narayanan
    Department of Computer Science and Engineering
    220 Pond Lab
    Pennsylvania State University
    University Park, PA 16802 
    Email: vijay@cse.psu.edu, Tel: 814-863-0392

Please provide the following details

Last Name __________________________ First Name ________________________

Organization: __________________________________________________________

Mailing Address: _______________________________________________________

City ____________  State __________  Zip ___________ Country ___________

Phone: ____________________  E-mail: ___________________________________
 
IEEE Membership Number ___________________  Student  Yes / No

Check Amount:  $ ________     

Check Number:  ________________ Bank Name _____________________________