Mail to:
  Mrs. Dania Puerto
  Spatial Ecology Workshop
  Department of Mathematics
  The University of Miami
  Coral Gables, FL 33124

REGISTRATION INFORMATION
Name: _______________________________________

Affiliation: _______________________________________

Mailing Address: _______________________________________

                         _______________________________________

Email Address: _______________________________________

Phone Number: _______________________________________

Fax: _______________________________________

Accompanying Guest/Spouse: _______________________________________
REGISTRATION FEES
Registration Fee
$200, waived for plenary speakers
     $____________
Number Attending Banquet
  ______
  
Banquet Fee
$50 per person
     $____________
Number of Extra Lunches
  ______
  
Extra Lunch Fee
$10 per extra lunch
     $____________
Total Fee
     $____________
PAYMENT INFORMATION
If paying by credit card, fill out the information below:
Name on Credit Card: _______________________________________

Card Type: (select one)    ___Visa    ___MasterCard

Card Number: _____________________________    Exp Date: ________

If paying by check, please make it for the total amount in US dollars made payable to the University of Miami and include it with this form.