Xilinx and FPGA workshop Pre-Registration Form

You MUST fill out this form to reserve a seat at the workshop, to reserve a free lunch seat, to reserve a copy of the workshop proceedings, and to receive email updates about the workshop and upcoming events. If you experience any technical problems submitting this form, please contact the workshop organizer at northjerseygold "AT" ieee "DOT" org

If you need to cancel your reservation, please contact the organizer immediately because there are only a limited number of seats for this workshop available to participants. All payments for registrations made on the website must be made in CASH at the workshop when picking up materials and after presenting valid IDs. If IDs are not available, the full Non-IEEE member, non-student charge will be assessed.

This form collects information to gather statistics on the audience who is interested in attending this workshop. It is also used to get a head-count for seating, ordering food, printing, etc. The information in this form will in NO WAY be made public to anyone outside of the organizers of this workshop. It is used primarily to communicate new information to the audience and keep them informed of events happening in the region.

Fields in BOLD are required for pre-registration to the workshop.

First Name: Last Name:

University/College name:

Current Year: Graduating in year:

Email Address:

Street Address Line1:

Street Address Line2:

City: State: ZipCode:

Phone # (abc-def-ghij):

Enter your registration status for payment.

Any FDU Student, ($5, bring valid FDU ID.) IEEE member and student, ($5, bring valid student id and IEEE member card.) Non-IEEE member and student, ($10, bring valid student id.) IEEE member and non-student, ($15, bring valid IEEE member card) Non-IEEE member, ($20.)

If you are an IEEE member, enter your membership number here:

I will have lunch and refreshments at the workshop (all FREE): YES NO

Special food restrictions ? Vegetarian ? YES NO

Comments, questions, suggestions ?? Please include them below.

Mailing List Info

If you would like to subscribe to the North Jersey Section GOLD Acitivities Mailing List to get regular email about this and other events like it in the greater NY-NJ Metro Area. Subscribe NOW. (Note: This is a low volume email list that distributes information one way and is used only for IEEE related business, addresses are not given out to anyone.)

If you have any troubles with the registration form, just email the organizer, northjerseygold "AT" ieee "DOT" org to register directly.