REGISTRATION FORM

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                           REGISTRATION FORM

                     STIPR'97 Workshop
                      Institute of Information Theory and Automation
                      Prague,  Czech Republic
                      June 9-11, 1997

Title, First name, Surname:  _______________________________________________

Address:  _________________________________________________

_________________________________________________________

_________________________________________________________

Telephone:  ___________________________

Fax:  ________________________________

e-mail:  ______________________________

Affiliation (for badge):  ________________________________________________


PAYMENT

1. Prior to 15 May 1997
___  $250 full registration fee
___  $150 reduced student's registration fee
         (proof of student's status will be required)

2. After 15 May 1997
___  $300 full registration fee
___  $200 reduced student's registration fee
     (proof of student's status will be required)

Amount Paid:  $________________

Method of Payment:

 Bank transfer to the account No. 6015-1726-081/0100,
 (variable symbol: 090697)
 at the: KOMERCNI  BANKA  a.s., Praha 8
         (Bank Code 0100)
         Podvinny mlyn 2
         180 41 Prague 8
          Czech Republic

Please, fill in your name and "STIPR'97"as the Purpose of payment, e.g
.:
"John Smith, STIPR'97"

For your information, the registration fee includes the proceedings,
coffee breaks, three lunches, ice-breaking party, banquet and the
sightseeing tour.  The official receipt of payment will be given to
you during the registration in Prague.

RETURN BY  MAY 9, 1997 (E-mail or by airmail) TO:

STIPR'97
Jiri GRIM
Institute of Information Theory and Automation
Pod vodarenskou vezi 4
P.O.Box 18
182 08 Prague 8
Czech Republic
Tel.: +(420) 2-6605 2505 (secretariat), Fax: +(420) 2-688 3031
e-mail: stipr97@utia.cas.cz

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