FAABS III

NASA Goddard/IEEE Workshop on Formal Approaches to Agent-Based Systems

26-28 April 2004 - Greenbelt, Maryland USA

To register electronically, visit the FAABS III home page at
[www.fmw.gsfc.nasa.gov](http://www.fmw.gsfc.nasa.gov/).

To register, fax or mail this form to the address at the right. IEEE
Computer Society

**[Payment must be received before 12 April 2004.]{.underline}** FAABS
III Registration

*Registration forms without payment **will not** be processed.* Dept.
6006. For questions

For questions please email us at <register@computer.org> or call
Washington, DC 20042-6006

\+ 1-202-371-0101 (*Sorry, no phone registrations*.) Fax +1-202-728-0884

Name:

*Mr.* *Ms* *­Dr.* *Prof. Last/Family Name First Name MI Badge Name*

Organization/Affiliation:

Address/Mail Stop:

City:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
State/Province: \_\_\_\_\_\_\_\_\_\_\_\_\_Zip:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Country:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Daytime Phone:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Fax:
E-mail:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Do not include my name and information on: Attendee List

**Membership Number (s)** IEEE / IEEE Computer Society Member
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Please check here if you would like to join the IEEE Computer Society's
technical committee(s) sponsoring this conference (there are no charges
or membership fees for joining Computer Society Technical committees.

**Yes, I would like to join the IEEE Computer Society technical
committees.**

**Please check all that apply:** *ADA Requirement(s)* Mobile Audio
Visual *Dietary Restriction* Vegetarian

**FAABS III Conference Registration: *(****Registration includes
admission to the conference, one copy of proceedings, breakfast, coffee
breaks, lunch, Sunday Reception, and Monday Banquet.)*

Advance Rate *(received prior to 22 March)*

Member US\$320.00

Non-Member US\$400.00

Student Members US\$250.00

Life Members US\$250.00

Student Non-Members US\$310.00

Late/Onsite Rate *(received after 22 March)*

Member US\$430.00

Non-Member US\$535.00

Student Members US\$300.00

Life Members US\$300.00

Student Non-Members US\$360.00

***Amount due for FAABS III Conference Registration***:
\$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

The following events are included with your FAABS III registration:

> **SUNDAY NIGHT RECEPTION** -- Please indicate if you will attend.

-   Sunday Reception

> **BREAKFAST** -- Please indicate the days you will attend:

-   Monday

-   Tuesday

> **LUNCH** -- Please indicate the days you will attend:

-   Monday

-   Tuesday

> **MONDAY NIGHT BANQUET** -- Please indicate if you will attend.

-   Monday Reception

**Additional Purchases:**

(QTY)\_\_\_ FAABS III Sunday Reception Ticket US\$50.00 US\$50.00

(QTY)\_\_\_ FAABS III Monday Banquet Ticket US\$75.00

Total Additional Purchases: \$\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Payment Information** (**NOTE: *Advance fees*** *apply only to
payments received on or before **22 March 2004**.*)

Registration forms with check payments must be received by **22 March**
or you will be required to register onsite, provide credit card
information, and to pay late fees [before]{.underline} attending the
conference.

**Method of Payment** (please select one): ***Total
Enclosed/Authorized:*
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

\_\_\_\_\_\_\_\_\_ American Express

\_\_\_\_\_\_\_\_\_ Diners Club

\_\_\_\_\_\_\_\_\_ MasterCard

\_\_\_\_\_\_\_\_\_ VISA

\_\_\_\_\_\_\_\_\_ Company Check

\_\_\_\_\_\_\_\_\_ Personal Check

Credit Card/Check Number:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Exp. Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Cardholder Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Signature:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Billing Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

City:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
State/Province: \_\_\_\_\_\_\_\_\_\_\_\_\_Zip:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Country:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\*NOTE: Advance registration fees apply to registrations received with
payment on or before 22 March 2004. **Checks will not be accepted after
22 March 2004**. Late fees apply to registrations and/or payments
received after 22 March 2004. All registrations must be received by 12
April 2004. Those received after this date will be required to register
and pay onsite.

Appropriate registration fees will be charged based on status (member,
student) information and on date registration form is received. Please
make checks payable to: "**IEEE Computer Society**". All checks must be
in US DOLLARS drawn on US BANKS. Credit card charges will appear on
statement as \"[IEEE Computer Society]{.underline}.\"
Cancellations/requests for refunds must be in writing and received
before 22 March 2004. Cancellations are subject to a \$50 processing
fee. **Substitutions will not be permitted.**

The IEEE Computer Society is not responsible for faxes not received due
to mechanical failure or circumstances beyond our control. Due to the
high volume of faxes received, we are unable to confirm receipt
immediately. Confirmations will be sent within 10 working days of
receipt of registration form. Online registrations will receive
confirmation by email. If you would like notification of receipt, we
recommend you register online, or send registration forms by a carrier
who can provide confirmation of delivery.

**Member and Student Member Discounts**

To qualify for discounted registration rates, include your current ACM,
IEEE or IEEE Computer Society membership number with the registration
form.

### Confirmation Letters -- Registration/Attendance

Confirmation letters are sent automatically online to those that have
registered online. Mail and fax registrations will be sent a
confirmation letter by email if, an email address is provided.
Otherwise, registration forms without an email address will have a
confirmation letter sent by postal mail within 10 days of receipt.

### 

### Visa Letters

Speakers, Committee Members and paid attendees requiring visa letters
must send an email to **[Michael.G.Hinchey@nasa.gov]{.underline}** with
a subject line "visa letter request".

Visa letters will only be issued to:

-   Speakers/Presenters

-   Committee Members

-   Attendees who have paid their registration fee in full and are not
    from one of the countries embargoed by the U.S. Treasury
    Department's Office of Foreign Assets Control (Cuba, Iran, Libya,
    and Sudan).

Visa letters will state only the following facts:

-   Conference title, dates and location.

-   That the requester has paid the required registration fee in full.

-   If they are a committee member, speaker or presenter.

**Cancellations**

Cancellations are allowed. However, full registration fees will be
charged unless a cancellation notice is received in writing on or before
**22 March 2004** to:

> IEEE Computer Society
>
> **Attn: FAABS III**
>
> Fax: +1-202-728-0884
>
> Email: register@computer.org

A \$50 handling fee will be applied to all canceled registrations. Fees
cannot be refunded for registrations canceled after the deadline.
No-shows will be billed.

Important Dates

+-----------------+----------------------------------------------------+
| > 22 March 2004 | > Advance registration ends 5:00 pm Eastern        |
|                 | > Standard Time.                                   |
+-----------------+----------------------------------------------------+
| > 22 March 2004 | > All check payments must be received. Originals   |
|                 | > only.                                            |
+-----------------+----------------------------------------------------+
| > 22 March 2004 | > Cancellation deadline -- All cancellations MUST  |
|                 | > be in writing.                                   |
+-----------------+----------------------------------------------------+
| > 12 April 2004 | > Late registration ends.                          |
+-----------------+----------------------------------------------------+

**Questions**

Please email register@computer.org or call +1-202-371-0101 and reference
FAABS III registration.