NAME: __________________________________________________________________

TELEPHONE: _____________________ E-MAIL: _______________________________

UNIVERSITY AFFILIATION:  _______________________________________________

DEPARTMENT:  _______________________   SOCIAL SECURITY #: ______________

ACM MEMBERSHIP NUMBER:   _______________________________________________

MAILING ADDRESS:  _________________________________________

                  _________________________________________

                  _________________________________________

THESIS ADVISOR: ___________________________________________
(Ask your advisor to send an e-mail to Matthew Farrens (farrens@cs.ucdavis.edu)
stating that you are a full time student pursuing an MS/Ph.D under
their supervision in an area covered by ISCA.)

LIST PAPERS ACCEPTED TO ISCA 2005

  1. TITLE:______________________________________________________________

     PAPER PRESENTER:____________________________________________________

  2. TITLE:______________________________________________________________

     PAPER PRESENTER:____________________________________________________

OTHER SERVICE TO ISCA 2005
(e.g. workshop presentation, give paper title and presenter)

___________________________________________________________________________

___________________________________________________________________________


OTHER SOURCES OF TRAVEL MONEY AND EXTENT OF NEED

___________________________________________________________________________

___________________________________________________________________________

ESTIMATED TRAVEL EXPENSES:

  TRAVEL FROM  ____________________________ To  Madison, WI, USA

      AIR-CARRIER TO BE USED:  __________________________

      ROUND TRIP COST: __________________________________

  LODGING: _______________________________________