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PDC 2000 Conference Registration Form

PDC 2000 Conference Registration Form     Print carefully to avoid errors on your name tag.

First and Middle Names:                                                                              Last Name:                                                                                



Mail or Fax Form to:


PDC 2000 Registration




P. O. Box 717


Palo Alto CA 94302

City,  State/Province:                                                                                                                                   



Fax: +1 650 322 4748

Postal Code:                                               Country:                                                                                   



Email Inquiries to:

Tel:                                                                                           Fax:                                                        




Conference Fees (All fees are listed in U.S. Dollars.)

Date Received On or before Oct. 20 Oct. 21 – Nov. 17 On-Site: Nov. 28 – Dec. 1
(Please circle the appropriate fee) Student Member Other Student Member Other Student Member Other
Conference Fee (US$)   85 175 275 105 225 325 115  250 350  

Workshops                      Included with conference registration. Selection will occur on-site.                 

Fee includes a ticket to the Thursday night banquet.   __ I will attend   __ I will not attend  __ I will attend with __ guests at $45 each.

NOTE:  A limited number of scholarships are available. One-day conference fees are also available. 
Please contact us at or phone (206) 783-3066 and leave a message if you are interested.


Space limited, Advance registration is required. You must register by Nov. 17                                                                               

Tuesday Tutorial (full day)                     $150.  (Does not require conference registration.  Limited to 20 participants.)

Payment  (Forms without payment will not be processed.)

 Payment Computation:                                Check all that apply:


New Membership in CPSR ($75)$           



I am a member of:  __ CPSR  __ ACM (ACM Member #                              )


Tutorial Fee: ($150)                      $           



__ a Cooperating or Co-sponsor Organization:                                               


Conference Fee:                            $           



____   Full-time student. (Please attach copy of ID or other verification.)


Extra Proceedings:       ___ x $25  $           



____   I have requested a scholarship.


Extra Banquet Ticket:___ x $45   $           



Method of payment:  (Please check one)             


TOTAL FEES:                            $             .



__  Check or money order enclosed, payable to "CPSR/PDC 2000".


Additional Info.:  (optional)



__ Fees paid for by another attendee (name):                                                         





__ MasterCard   or  __ VISA   (we can only process these) Please complete:

Highest Educational Level:




Card #                                                                                                                         Expires:                                                                                  

Registration, Title, or Other Affiliation:




Cardholder’s Name:                                                                                                 

How did you hear about PDC 2000?



Cardholder’s Signature:                                                                                            



Please attach billing address if different from above.

___ I have special needs (please attach a description):        

 CPSR The Participatory Design Conference is sponsored by Computer Professionals for Social Responsibility.

Archived CPSR Information
Created before October 2004

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