RIKEN BNL Research Center Workshop

	         Quantum Fields In & Out of Equilibrium
                            Oct. 26-30, 1998
                            REGISTRATION FORM

Name: _________________________________________________________________

Title: ________________________________________________________________

Affiliation: __________________________________________________________

Mailing Address: ______________________________________________________

                 ______________________________________________________

                 ______________________________________________________

Telephone: __________________________ FAX: ____________________________

E-Mail Address: _______________________________________________________

Arrival Information:

     Date/Time of Arrival ________ / ________ Airport _________________

                  Airline/Flight No. ______________

     Date/Time of Departure _______ / ________ Airport ________________

                  Airline/Flight No. ______________


Please make limousine reservations on arrival and departure _______________

(Note: we need COMPLETE flight info in order to make a limo reservation.)

On-Site Housing Request:

     Arrival date _________________  Departure date ___________________

Dorm Room:   Female ____________     Male ______________

Other Accommodations: Single _____ 
                      
                      Double ______ Sharing with ______________________

I prefer to make my own reservation at a hotel ________________________

Further comments about travel and accomodations, if any:
	
	_______________________________________________________________

Title and Abstract of Presentation_____________________________________

        _______________________________________________________________

        _______________________________________________________________

        _______________________________________________________________

Please send this form to 
       
      Ms. Pamela Esposito
      RIKEN BNL Research Center
      Building 510A, Brookhaven National Laboratory
      Upton, NY 11973, USA
      Phone: 1-516-344-3097  Fax: 1-516-344-4067
      E-Mail: rikenbnl@bnl.gov