REGISTRATION FOR INTERFACE 2004

(Please type or print legibly.)

Name (as will appear on nametag) _______________________

Affiliation __________________________________________

Address ___________________________________________

Please check if ____ work or ____ home

City _________________________ State _____ ZIP ________

Phone __________________ e-mail _______________________

========= On or before April 9th, 2004 ====================
____ Interface Foundation of North America (IFNA) Membership $35
____ Interface Registration (for IFNA Members) $215
____ Interface Registration (for Members of Cooperating Societies - see list below) $250
____ Interface Registration (for Full-time Students) $110
____ Interface Registration (all others) $295
____ Registration for a Single Day of Interface (No Banquet, no CD) $130

========= After April 9th, 2004 ========================
____ Interface Foundation of North America (IFNA) Membership $35
____ Interface Registration (for IFNA Members) $265
____ Interface Registration (for Members of Cooperating Societies - see list below) $300
____ Interface Registration (for Full-time Students) $150
____ Interface Registration (all others) $350
____ Registration for a Single Day of Interface (No Banquet, no CD) $150

===============================================
____ Banquet (for Single Day Registrants or Guests) $50

========= Short Courses: On or before April 9th, 2004 ============
Leo Breiman and Adele Cutler, Random Forrests
____ Random Forrests (IFNA/Cooperating Societies Member) $165
____ Random Forrests (Non-IFNA/Cooperating Societies Member) $225
____ Random Forests (Full-Time Student) $75
Rafael A. Irizarry, Gene Expression Analysis
____ Gene Expression Analysis (IFNA/Cooperating Societies Member) $165
____ Gene Expression Analysis (Non-IFNA/Cooperating Societies Member) $225
____ Gene Expression Analysis (Full-Time Student) $75
Both Courses
____ Both Courses (IFNA/Cooperating Societies Member) $225
____ Both Courses (Non-IFNA/Cooperating Societies Member) $350
____ Both Courses (Full-Time Student) $100

========= Short Courses: After April 9th, 2004 ================
____ Late fee for short courses after 4/9/04 or when upgrading from 1 to 2 short courses $30

_____ TOTAL $_____


Notes: