CTAC 2001 REGISTRATION FORM
                 http://conference.maths.uq.edu.au/ctac2001/
                               16-18 July 2001
                       Brisbane, Queensland, Australia


DATE OF COMPLETION OF THIS FORM:
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PARTICIPANT
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         Title:         
    First Name:
   Family Name:
        E-mail:
  Organization:
       Address:
          City:            
State/Province:
       Country: 
 Zip/Post code:
         Phone:
           Fax:
Supervisor/advisor (for a student):


REGISTRATION FEE
(cover attendance at the conference, welcoming cocktail party, morning
and afternoon tea/coffee, conference hand-outs, and the conference dinner)

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                    Early bird            Late
                   Registration       Registration
                  by 15/June/2001    by 01/July/2001

Standard            [ ] A$240           [ ] A$280

ANZIAM member       [ ] A$220           [ ] A$260

CTAC99 attendee     [ ] A$200           [ ] A$240

Concession          [ ] A$90            [ ] A$150

(All figures are inclusive of GST.)


CONFERENCE DINNER
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Please specify the number of additional seats to reserve at the conference 
dinner for accompanying persons (A$60 per seat).

__  additional seat(s) at the conference dinner


PAYMENT METHOD
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If you wish to pay by cheque or do not wish to send your credit card
details on the net, the postal mail address for notifying us how to clear
your payment is:

    CTAC 2001 Conference
    Department of Mathematics
    The University of Queensland
    St. Lucia, QLD 4072
    Australia

The fax number for notifying us of credit card details is:
    +61-7-3365-6136

    Please indicate on your fax that it is for the attention of the
    CTAC 2001 organisers.

-------------------------------------------------------------------------
Please tick the appropriate boxes for your payment method.

[ ] Check in Australian dollars payable to The University of Queensland


[ ] Please charge my credit-card with A$______

    [ ] Visa    [ ] Mastercard

    Name on credit card:

    Billing address (of card holder):
    City:                 
    State:  
    Zip/Post Code:

    Credit card number:  
    Expiry date (MM/YY): 

    Signature:
    (not required for the electronic registration via the form on the web)


[ ] I request a receipt now (otherwise receipt will be issued at the
    conference)



PAPER SUBMISSION
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If you will be presenting a paper, please answer the following questions
as appropriate.


Title of your paper:


Abstract:

























Particular comments: