DOE Computer Graphics Forum

May 2-5, 1999

Granlibakken Conference Center

Tahoe City, CA   96145


First Name                                            Middle Initial                                     Family Name

Organization or Affiliation

Organization Address

City                                         State                                     Postal Code                            Country         

_____________________________                                                ____________________________
Organization Telephone                                                                      FAX Number

Email Address

[    ] I have the following special needs________________________________________

[    ]     Male  [     ]    Female
LODGING (includes 3 night’s lodging, 3 full breakfasts, 3 lunches, 2 dinners, use of  recreational facilities.  Should you require additional nights lodging, please contact Local Arrangements Coordinator Roberta Boucher

Single Occupancy $333.00 per participant                                                          $____________

Guest/Spouse   $162.00 per person                                                                    $____________
  (this rate applies to guests sharing a single occupancy room with a participant)

Total Lodging Costs                                                                                           $____________

REGISTRATION (covers meeting materials, coffee breaks, facility charges, and other meeting costs)

Registration Fee            $242.00                                                                        $____________

TOTAL FEES (LODGING + REGISTRATION)                                              $____________

We are unable to accept International Postal Money Orders, or Eurochecks.
Please enclose check in U.S. dollars drawn on a U.S. bank or International Money Order payable to:  REGENTS, UNIVERSITY OF CALIFORNIA

We accept payment by mail or fax using either Visa, Mastercard, Diners Club, JCB or Carte Blanche.
Please complete the following information:

_______________           ___________________________________          _________________
Type of credit card            Credit card Number                                                 Expiration date

_________________________________                                    ___________________________
Print name as shown on credit card                                                 Signature

Return this form with your payment before March 31, 1999 to:

Conference Coordinator
Lawrence Berkeley Laboratory
Mailstop 936A
Berkeley, California  94720  USA
FAX:  (510) 486-6282


Cancellations must be received in writing before April 18th, 1999.  A $100.00 handling charge will fee will be charged to all cancellations before April 18th.  Refunds will not be possible after April 18th.

Lodging at Granlibakken is sold as a package, with arrival Sunday, May 2nd and departure Wednesday, May 5th. Refunds cannot be given for late arrivals or early departures.