CCSC Student Registration Form
Eastern 2004 Conference on Oct. 15-16, 2004

Registration includes the following: admission to all sessions, proceedings, banquet, and luncheon

 

Friday Banquet Preference:  (check one)

Vegetarian Yes             No

 

Type (please circle one):                   presenter, programmer, volunteer, other _________
Name: ____________________________________________	Email:  _________________________________________________
Faculty advisor: ____________________________________	Institution: _______________________________________________

        Please circle if you do not wish your name included in a published participant list.
 

        Please circle if you do not want to be added the CCSC listserver(s).
 

Please write checks or money orders payable to CCSC.  CCSC does not accept credit cards.

The Consortium will assess a charge of $25 for each check returned.

Please mail this form to the following:

Richard Brown Department of Computer Science Loyola College in Maryland 4501 North Charles Street Baltimore, MD 21210-2699 Phone: 410-617-2095 Fax: 410-617-2157 E-Mail: rbrown@loyola.edu

For more information, please see: http://justice.loyola.edu/ccsce04 and/or http://www.ccsc.org/

Regions are: Central Plains, Eastern, Midwest, Northeast, Northwest, Rocky Mountain, South Central, Southeast.