Last name:
Affiliation:
Country:
The information above will be used for name tags and receipts.
I don't mind the information above appearing on a public list of registrants.
Email address (not for publication):
I confirm that this is my email address, and I agree to receive email at this address about DIAC 2013.
I plan to attend the excursion on Sunday 11 August. (No extra charge.)
I plan to attend the dinner on Sunday 11 August. (No extra charge.)
I plan to attend the dinner on Monday 12 August. (No extra charge.)
Dietary restrictions:
I understand that UIC charges a $100 registration fee for DIAC 2013. I will pay the registration fee in cash in the morning of Monday 12 August.