REGISTRATION FORM DISC'99 13th International Symposium on DIStributed Computing September 27-29,1999, Bratislava, Slovakia Please, fill in (type or use block letters) and return this form together with a proof of payment to the Organizing Committee. For early registration the registration form must reach the Organizing Committee not later than August 4, 1999. ___ Mr. ___ Ms. First name(s):........................................... Family name : ............................................................. Nationality : ............................................................. Affiliation : ............................................................. Address : ............................................................. E-mail : .......................................... ___ Vegetarian meals Phone : .......................................... Fax : .......................................... ___ Early registration (before Aug 4, 1999) 310 US$ ___ Late registration (after Aug 4, 1999 ) 340 US$ ___ Accompanying person (before Aug 4, 1999) 130 US$ ___ Accompanying person (after Aug 4, 1999) 150 US$ ___ Single room 30 US$ ____________ Total amount: ....... US$ ___ Please, charge my credit card __ VISA __ EUROCARD/MASTERCARD Card No.: .................................. Exp. Date: ................ Name: .................................................................... Address: ................................................................. Date: ................................... Signature: ................................... ___ I paid by bank transfer on ............... to the account given below: Beneficiary: Slovak Society for Computer Science Account #: 2623081336/1100 Bank: TATRA BANKA, Bratislava Branch SWIFT Code: TATR SK BX Details of Payment: DISC'99 -