PARTICIPANT INFORMATION

Please provide the following information about yourself:

First Name:

Last Name:

Address:     Institution

Street address line 1

Street address line 2

City - zip - (State) - Country

Email:

Telephone:

Fax:

Affiliation as you want it to appear on your conference badge:

Membership status in the ASSC: Full Member  Student Member  Non Member

WORKSHOP REGISTRATION

If you wish to attend one of the workshops listed below, please indicate your first and second choices. Note that you can attend two workshops: One in the morning, and one in the afternoon. If you would like to take part in two workshops, please rank order your choices separately for the morning and afternoon sessions. The registration fee is 2000 BEF per workshop (in addition to the conference fee).

Thursday Morning, June 29th

Thursday Afternoon, June 29th

	W01: Frith & Rees [FULL]		W07: Lloyd [FULL]
	W02: Reber & Paller		W08: Rensink & Simons
	W03: Metzinger & Engel		W09: Andrade & Jones
	W04: Cole, Depraz & Gallagher		W10: Baars, Tononi & Bickle [FULL]
	W05: Rosenthal		W11: Keenan [CANCELLED]
	W06: Revonsuo		W12: Velmans

CONFERENCE DUES

Select your conference fee from the table below and type the corresponding amount in the "Registration fee" box. To be eligible for the reduced student fee, please fax a copy of a valid student I.D. to +32 2 649 58 03. Cancellation: Notify us in writing before May 4th, 2000 to receive a refund (minus a 30% cancellation fee). Non-attendance does not constitute cancellation.

Registration fees:	Early	Late
Non-Members	6000 BEF	8000 BEF
ASSC Members	5000 BEF	7000 BEF
Students	2500 BEF	3000 BEF
Student ASSC Members	2000 BEF	2500 BEF

Note: All fees should be paid in Belgian Francs.
1 USD = approx. 40 Belgian Francs = approx. 1.00 EURO.

PAYMENT

Please select your method of payment below. If paying by credit card, please complete the relevant data.

	Eurocheque in BEF payable to "ASSC4"
	Bank transfer to account CGAKBEBB #001-3368044-86 (Fortis/CGER bank) mentioning "ASSC4 registration" and your name
	Credit Card: AMEX   VISA   EURO/MASTER   DINER'S
	Card Number:   Expiration (mm/yy):
	Name on Card:

ACCOMODATIONS

If you wish to reserve a hotel room through the conference secretariat, please indicate your times of arrival and departure below and rank order your first two choices among the listed hotels. Accomodations in the "Centre Sportif de la Forêt de Soignes" will be allocated in priority to students who request it. All accomodations will be allocated on a first-come, first-served basis. No downpayment is required to secure reservation. All bookings will be confirmed with you. More information about the hotels, including costs, can be found on the "travel info" pages on this site.

June 16th Note: The following hotels are now fully booked: Brussels Hotel, Centre Sportif, Golden Tulip Atlanta, La Madeleine.

BEAM IT UP!