ANTS 6 Registration Form

Please fill out this form, print it off, and fax it to
+1-802-656-0306.
You will receive email confirmation of receipt of your registration.

Information

Family Name:

Personal Name:

Affiliation:

Email Address:

Postal Address:

City:

State or Province:

Postal Code:

Country:

Fees

If you are using the student rate you will need to include a letter from your major professor.

Conference Fee (Regular US$30, Student US$10)

Copy of the conference proceedings (Regular US$30, Student US$20)

Conference banquet (Regular US$20, Student US$10)
The banquet will be a buffet dinner cruise on the Spirit of Ethan Allan

Guest for banquet (US$20) (Each Conference attendee may bring one (1) guest.)

Residence hall accommodations (optional)

Conference participants are expected to make their own accommodation reservations. A list of local hotels is available; alternately you can stay in a room in a unversity residence hall. Residence hall rooms include linen and have communal bathrooms at the end of the hall. The residence halls are not air-conditioned. Residence hall rooms are available from Saturday 12 June through Saturday 19 June. You must follow the residence hall policies and procedures. Rates:
US$30 per night single occupancy
US$25 per night double occupancy

If you would like to stay in a residence hall room, please fill out this section.

Arival date:

Departure date:

Single or double?

If requesting double room, will be rooming with

Total residence hall fee

On-campus parking for automobiles (optional)

If you will be parking an automobile on campus, please choose either the weekly or daily rate. Parking is free of charge on Saturday and Sunday.

The weekly (Monday - Friday) rate is US$24.00

The daily rate is US$5.00 per day. Indicate number of days and total amount.

Payment method

You may either pay by credit card or by certified bank check in US funds made payable to the University of Vermont sent to

Algorithmic Number Theory Symposium
Continuing Education
322 South Prospect Street
Burlington, VT
05405
+1-800-639-3210
+1-802-656-2085 (option 5)
+1-802-656-0306 (fax)
I will pay by (check, credit card)

Credit card type: (Mastercard, Visa)

Credit card number:

Expiration date:

Total payment: (all fees, residence hall, parking)

Signature:

Questions? - send email to ants@hermes.ewlab.usna.edu