FTP'98 - Registration Form
          Schloss Wilhelminenberg, Vienna, November 23-25, 1998
                   

Personal Data
=============
    
Participant:      [ ] Prof.  [ ] Dr.  [ ] Mrs.  [ ] Ms.  [ ] Mr. 
Family Name:      
First Name:       
Affiliation:      
Mailing Address:  
                  
                  
Country:          
E-mail:           
Phone:            
Fax:              


Conference Fee
==============

Regular participant:
  - by Nov. 15 1998:  ATS 1900,-- (approx. ECU 138,--, USD 164,--) 
  - after this date:  ATS 2200,-- (approx. ECU 160,--, USD 190,--)

The conference fee includes
  - proceedings
  - refreshment breaks
  - 3 lunches (hors d'oeuvre, main meal, dessert)
  - social event
  - conference facilities

Accompanying person:
  Fee depends on whether s/he wants to join for lunches or social event,
  and can be settled on site.

Concerning lunch: vegetarian food is no problem; if you need
a special diet, let us know as soon as possible.


Payment
=======

Registration fee (see above):  ATS ____________,--


Please choose one of the following forms of payment:

[ ] CREDIT CARD
    I entitle the "Kurt Goedel Society" to charge my credit card
    with the above total fee.
    
          [ ] VISA         [ ] Mastercard/Eurocard

    Card Number:
    Expiration Date:
    Card holder's name:
    Address:



         ____________               __________________________________
            (Date)                        (Authorized Signature)


[ ] MONEY ORDER
    I have remitted the above total fee on ________________________ (Date)
    to the account
       FTP98 (Gernot Salzer)
       No. 1064-51776/00
       Routing code 11000
       SWIFT code   CABVATWW
       Bank: Creditanstalt, Rilkeplatz 8, A-1040 Wien, Austria
    I add a copy of the transfer form to confirm the remittance.
    
Note: please make sure that the whole amount arrives at the FTP98 account,
without deduction of transfer fees.

[ ] EUROCHEQUE
    I enclose a bank cheque for the above total fee plus ATS 80,--
    (= fee charged by the bank for cashing the cheque)
    payable to the account
       FTP98 (Gernot Salzer)
       No. 1064-51776/00
       Bank: Creditanstalt, Rilkeplatz 8, A-1040 Wien, Austria



PLEASE SEND THE COMPLETED FORM BY SURFACE MAIL TO:
    Franziska Gusel
    Technische Universitaet Wien
    Karlsplatz 13/E185-2
    A-1040 Wien
    Austria
Please send also a short e-mail to  ftp98@logic.at  to announce that
we should receive your registration form within the next days.

In case of a money order, you can also send the registration form
and the copy of the transfer form by fax:
    Fax: +43(1)5041589 

In some countries the post offices offer the possibility to transfer money
directly to a person, which is cheaper than an ordinary money order.
If you intend to choose this method, you will need my private address.
Request it by e-mail to "ftp98@logic.at".