COMPANION TRAVEL APPLICATION FORM

NAME: __________________________________________________________________

TELEPHONE: _____________________ E-MAIL: _______________________________

UNIVERSITY AFFILIATION:  _______________________________________________

DEPARTMENT:  _______________________   SOCIAL SECURITY #: ______________

ACM MEMBERSHIP NUMBER:   _______________________________________________

MAILING ADDRESS:  _________________________________________

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LIST PAPERS ACCEPTED TO ISCA 2003

  1. TITLE:______________________________________________________________

     PAPER PRESENTER:____________________________________________________

  2. TITLE:______________________________________________________________

     PAPER PRESENTER:____________________________________________________

OTHER SERVICE TO ISCA 2003
(e.g., workshop presentation with paper title and presenter, committee membership)

___________________________________________________________________________

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REASON FOR REQUEST, OTHER SOURCES OF TRAVEL MONEY, AND EXTENT OF NEED

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ESTIMATED TRAVEL EXPENSES:

  TRAVEL FROM  ____________________________ To  San Diego CA

      AIR-CARRIER TO BE USED:  __________________________

      ROUND TRIP COST: __________________________________