WORKSHOP REGISTRATION FORM

Name:_________________________________ Telephone:_________________________

Email Address:_______________________________________________________________

Mailing Address:_____________________________________________________________

___________________________________________________________________________

Business/Academic Affiliation:__________________________________________________

Registration Fee (includes buffet lunch, with a vegetarian option):

Postmarked with payment on or before April 27:

____Regular @ $65 ____Full-time student @ $25

Postmarked after April 27 or paid at the Workshop:

____Regular @ $70 ____Full-time student @ $30

Note: Only full-time students qualify for the student rate.

Those who register and/or pay after April 27th will have to pay for parking.

The cost is $2 and exact change (dollar bills or quarters) is required.

Make your check payable to "Workshop in Applied Statistics" and return it with this form to:

Anita Iannucci

The UCI Center for Statistical Consulting

University of California

Irvine, CA 92697-5105

Please enclose a stamped, self-addressed envelope (we strongly recommend a home address) for return of your parking permit, registration confirmation, and directions to the event.

For further information: Nancy Berman at berman@gcrc.humc.edu or 310-222-1874;

SCASA’s web site: http://orion.oac.uci.edu/~rnewcomb/statistics/scasa/scasa.html.