MeshForum Registration Form

Please see the online verson to pay electronically.

Attendee Information (please fill out for each attendee)


Full Name: _________________________
Name on badge: ____________________
Title: _____________________________
Affiliation: _________________________
Mailing Address:
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Contact Phone: _____________________
eMail Address: ______________________

Are you interested in being on a panel or being a session leader at MeshForum?: ___

What area(s) of Networks interest you?:
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In what area(s) of Networks are you an expert? (cite examples, publications, etc if you like):
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Blurb / Bio (Please include anything you would like to have potentially listed in the program book with your name and affiliation. URL's, Book Title, etc. are welcome.)
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Registration Details

Early Pre-registration: $900 $750 / person before March. 17th, 2005
Pre-registration: $1200 / person before April 15th, 2005

Registration AFTER April 15th will not be accepted via mail though may be available online.

Are you a Professor, Staff or full-time student? If Yes, please give the name of your institution and your affiliation above, you will get a discount of $250 off either registration.


Do you plan on staying at a hotel while in Chicago? If so and you would like us to contact to you as soon as hotel arrangements for MeshForum have been made? Please check here and be sure to leave us a way to directly reach you (email preferred). ___


Number of attendees registering: ______
Total enclosed: _______

Checks or Money Orders should be made out to MeshForum

Please mail completed form and registration fee to
MeshForum
attn. Shannon Clark
333 W. North Ave, #160
Chicago, IL 60610