Workshop Registration Form

DIMACS/MACS Workshop on Cryptography for the RAM Model of Computation

June 8 - 10, 2016

Please fill out the following form to register. Required fields are marked with *.

When finished and you have checked the correctness of information, press the "send" button at the bottom of the form.

Attendance is limited to available space; please register early. 

       






           Your First Name: 
           *Your Last Name: 


            *Your Position: 



Your Postal Address: (This information will be used for nametags & mailing lists)
      Name of organization: 
                            (University or Company Name)


        *Organization Type:  
                Department: 
            Street Address: 
     City, State, Zip Code: 
                   Country: 


                     Phone:  
                       Fax: 
                   *E-Mail: 
              Web page URL:

Comments: (i.e. dietary restrictions)


To prove you are not a robot, please compute the sum:


The event organizers have granted me a registration fee waiver.
The event organizers have not granted me a registration fee waiver.
This status will be verified prior to the event.
DIMACS Home Page