Registration Form
(please type or print)

10th International Conference on And-Arm Vibration
June 7 -11, 2004
Las Vegas, Nevada USA

First Name________________________________________	Last Name_______________________________________________

Organization/Company______________________________________________________________________________________

Mailing address_____________________________________________________________________________________________

___________________________________________________________________________________________________________

City______________________________________________	Postal/Zip code____________________________________________

Country__________________________________________	E-mail___________________________________________________

Telephone_________________________________________	Fax_____________________________________________________

Nunber of accompanying persons______________________	Name(s)__________________________________________________

Transport/arrival and departure dates:

	Plane______	Car________
Arrival	Departure
Day________________Time____________	Day_____________________Time________________
(mm/dd/yy)	(mm/dd/yy)

Conference Registration Fees	Before March 31. 2004	April 1 - May 31, 2004

Delegate	$590 USD	$643 USD	__________

Accompanying person(s)	$130 USD	$180 USD	__________

				Total	        =========
Lunches ( for delegates only, included in registration fee)			

	Mon.  6/7 _____	Tues.  6/8______	Wed.  6/9_____ 	Thurs.  6/10_____	Fri. 6/11_____

Dinners ( for delegates and accompanying persons, included in registration fee)

Monday evening, 7 June	Pool Party and Western Bar-B-Que            	Yes___ No___ 	No. of persons _____

Thursday evening, 10 June	Gala dinner w/entertainment	Yes___ No___ 	No. of persons_____

Methods of payment:

Credit Card:	____VISA  ____MASTERCARD    Name of Cardholder_____________________________________________

	Card No. ___________________________________________________Expiration Date___________________

Bank or postal cheque payable to HAVC 2004 in U.S. Dollars

Please return this registration form to:  HAVC 2004, 3939 Briarcrest Court, Las Vegas, NV 89120-1305, USA
or Fax to:  1-702-454-0085 or Email to: lkr@fremont.vegasnet.org
Telephone 1-702-458-1681