******Boston Area Architecture Workshop (BARC-2003)******
                          	        REGISTRATION FORM

___Professor
___Dr.
___Mr.
___Mrs.
___Ms.

Last Name:
First Name:
Organization/Company/School:

Affiliation:
___Industry
___Academic (non-student)
___Student

If you are a student, please provide the name of your faculty sponsor:

Address:


Telephone:
Email Address:
Dietary Restrictions:
___None
___Vegetarian
___Kosher
___Other

Do you want your name and email address to be included on the attendee list?
___Yes
___No

***************************************************************
Registration fees: 
Industry: $150.00
Academic (non-student): $50.00
Student: *WAIVED*
Total Due:

Please fill out all fields on this form.  You may either print out and
mail your completed form along with your registration check to the
address below, or email your form to shireen@cag.lcs.mit.edu, mailing
any checks separately.

**PLEASE NOTE: The deadline for BARC-2003 registration and payment is TUESDAY, 
JANUARY 14, 2003.

Checks must be payable to MIT.  Please remember to include your name on your 
check.  Checks should be sent to:

Shireen Yadollahpour
MIT Laboratory for Computer Science
200 Technology Square, NE43-620
Cambridge, MA 02139 U.S.A.