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<tr> <td width="200" valign="top"> <table width="190" border="0" cellspacing="0" cellpadding="0" align="left"> <tr> <td width="10" height="30"><br> <br> </td> <td width="15"> </td> <td width="165"> </td> </tr> <tr><td> </td><td colspan='2'><a href='../../advanced%20networking/index.php'>advanced networking</a><br></td></tr><tr><td> </td><td colspan='2'><a href='../../krypto/index.php'>krypto</a><br></td></tr><tr><td> </td><td> </td><td><a href='../AES/index.php'>AES</a><br></td></tr><tr><td> </td><td> </td><td><a href='../events/index.php' class='red'>events</a><br></td></tr><tr><td> </td><td> </td><td><a href='../KinderUni/index.php'>KinderUni</a><br></td></tr><tr><td> </td><td> </td><td><a href='../members/index.php'>members</a><br></td></tr><tr><td> </td><td> </td><td><a href='../publications/index.php'>publications</a><br></td></tr><tr><td> </td><td> </td><td><a href='../topics/index.php'>topics</a><br></td></tr><tr><td> </td><td colspan='2'><a 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</tr> </table> <h2>Registration Form</h2> <p>Workshop on RFID and Lightweight Crypto<br> July 14 - 15, 2005<br> Graz University of Technology, Graz, Austria</p> <p>Please fill out the online registration form below or fill out and fax the <a href="registration_workshop_ECRYPT_RFID.pdf" target="_blank">PDF form</a>.<br> If you have any questions please contact <a href="mailto:rfidinfo@iaik.tugraz.at">rfidinfo@iaik.tugraz.at</a>.</p> <p>The deadline for early registration is June 15th, 2005.<br> <strong>Registration is possible until July 8th, 2005.</strong></p> <hr> <form action="/research/krypto/events/registration.php" method="post"> <table width="100%" border="0" cellpadding="4" cellspacing="4"> <tr> <td width="35%">First name</td> <td width="65%"><input name="first_name" type="text" id="first_name" size="40"></td> </tr> <tr> <td>Last name</td> <td><input name="last_name" type="text" id="last_name" size="40"></td> </tr> <tr> <td>Affiliation</td> <td><input name="affiliation" type="text" id="affiliation" size="80"></td> </tr> <tr> <td>Street</td> <td><input name="street" type="text" id="street" size="40"></td> </tr> <tr> <td>Postcode/zip</td> <td><input name="postcode" type="text" id="postcode" size="10"></td> </tr> <tr> <td>City</td> <td><input name="city" type="text" id="city" size="40"></td> </tr> <tr> <td>Country</td> <td><input name="country" type="text" id="country" size="40"></td> </tr> <tr> <td>Email address</td> <td><input name="email" type="text" id="email" size="40"></td> </tr> <tr> <td>Phone (inluding country code)</td> <td><input name="phone" type="text" id="phone" size="40"></td> </tr> <tr> <td>Fax (including country code)</td> <td><input name="fax" type="text" id="fax" size="40"></td> </tr> <tr> <td>Type of registration</td> <td><select name="type_of_registration" size="1" id="type_of_registration"> <option value="Early registration (100 EUR)">Early registration (until June 15th, 100€)</option> <option value="Registration (120 EUR)">Registration (after June 15th, 120€)</option> </select></td> </tr> <tr> <td>I will attend the reception on Wednesday evening</td> <td><input name="reception" type="radio" value="yes">Yes<input name="reception" type="radio" value="no">No</td> </tr> <tr> <td>I will attend a guided tour through the city of Graz (1 hour) on Thursday evening (before the banquet)</td> <td><input name="city_tour" type="radio" value="yes">Yes<input name="city_tour" type="radio" value="no">No</td> </tr> <tr> <td>I will attend the banquet on Thursday evening</td> <td><input name="banquet" type="radio" value="yes">Yes<input name="banquet" type="radio" value="no">No</td> </tr> <tr> <td>How many <b>extra</b> guests are attending the banquet (65€ per person)?</td> <td><input name="banquet_extra_persons" type="text" id="banquet_extra_persons" size="10"></td> </tr> <tr> <td>How many persons attending the banquet are vegetarian (including yourself)?</td> <td><input name="banquet_vegetarians" type="text" id="banquet_vegetarians" size="10"></td> </tr> <tr> <td> </td> <td> </td> </tr> <tr> <td colspan="2"><input type="submit" value="Submit Registration"> <input type="reset" value="Clear Form"></td> </tr> </table> </form> <hr> <table width="100%" border="0"> <tr> <td colspan="2"><p><strong>Notes:</strong></p> <ul> <li><strong>Payment</strong><br> Please transfer the registration fee free of charges to our account:<br> Receiver: Technische Universität Graz<br> Account No.: 51656 101 816<br> IBAN: AT79 1200 0516 5610 1816<br> BIC (SWIFT code): BKAUATWW<br> Bank: Bank Austria CA, Leonhardstraße 21, 8010 Graz, Austria<br> Purpose: Workshop RFID & Lightweight Crypto</li> <li><strong>IMPORTANT!</strong> You have to make the transfer free of any bank charges for us, otherwise we will collect the charges on site!</li> <li><strong>IMPORTANT!</strong> You have to fax (+43 316 873 5520) a copy of the bank transfer receipt together with a printout of the registration confirmation page or the completed registration form (available in pdf) to us! As long as we do not get a proof of payment or do not receive the money transfer, you are not registered.</li> <li><strong>Cancellation</strong><br> The registration fee will be returned in full for any written cancellation before May 30th, 2005. No refund will be made in case of a cancellation received after this date.</li> <li>The workshop registration fee includes the reception on Wednesday evening, the city tour and the banquet on Thursday evening, the workshop handouts containing the submissions, coffee breaks and lunches.</li> <li>Registration will have to be carried out via this web-site and all fees will have to be paid in advance by bank transfer.</li> </ul></td> </tr> </table> <!-- #EndEditable --><br> <br> <br> </td> </tr> </table> </td> </tr> </table> <table width="95%" border="0" cellspacing="0" cellpadding="0"> <tr> <td align="right" width="100%"> <table width="580" border="0" cellspacing="0" cellpadding="0"> <tr> <td width="580" height="20" align="right" background="../../../pics/bgfuss.gif" colspan="2"> <div class="swpx"><a href="#" class="swnu" onMouseOver="status='...on top'; return true;" onMouseOut="status=''; return true;">top </a> </div> </td> </tr> <tr> <td height="5" align="right" colspan="2"><img src="../../../pics/linie.gif" width="442" height="5"></td> </tr> <tr> <td width="138" height="20"> </td> <td width="482" height="20"><span class="timesisw">copyright© 2001 by IAIK</span><img src="../../../pics/spacer.gif" width="15" height="3" border="0"><a href="mailto:webmaster@iaik.at" class="timesiblu">webmaster@iaik.at</a><img src="../../../pics/spacer.gif" width="15" height="3" border="0"><span class="timesisw">last update: May 06 2005</span></td> </tr> </table> </td> </tr> </table> </body> <!-- #EndTemplate --></html>