REGISTRATION FORM


                      WESTERN NUMBER THEORY CONFERENCE

              December 16-20, 2000        University of San Diego


    _____________________________      Registration fees:
    Name                               Regular($50), Student/Unemployed($25) $ ______

    _____________________________      Banquet tickets (Sat. Dec. 16)

    Institution/Organization           Aegean Chicken  ____ @ $ 23  =        $ ______
                                       Sole Florentine ____ @ $ 23  =        $ ______   

    _____________________________      Vegetarian      ____ @ $ 23  =        $ ______
    Address

    _____________________________              TOTAL ENCLOSED                $ ______
                                               (* U.S. funds  )

    _____________    _______________________
    Phone            E-mail address




   Please mail a copy of this form along with your check made payable
   to the  WESTERN NUMBER THEORY CONFERENCE  by NOVEMBER 17 to

                           Ron Evans
                           4206 Camino Lita
                           San Diego, CA 92122

   Those providing Email addresses will be notified promptly of receipt.

   To help us organize the conference and serve you better, kindly respond to
   the questions below.

   Please check which of the following excursions (if any) you would like to
   go to on Monday afternoon, December 18:

      Visit to the world famous San Diego Zoo ($23, all afternoon)  _____
      Harbor cruise of San Diego Bay ($18 for two hours)            _____
      Visit to nearby Sea World Park ($33, all afternoon )          _____
      Whale watching cruise ($21.50, all afternoon )                _____

  Will you have a car available for transportation at the conference?   _____
  If so, on Monday afternoon, how many riders would you be willing to
  transport to the excursion you indicated above?                       _____

  Do you plan to provide a brief (10-12 minute) talk at the conference? _____
  If so, please provide its title below (if known).

    _____________________________________________________________

  Arrival date & time ______________    Departure date & time _________________


  * Attendees from abroad may pay in cash upon arrival.  They may arrange
  to register electronically by contacting Ron Evans at "revans@ucsd.edu".