Ada-Belgium Ada Course Registration
________________________________________________________________________

Please mail to                       or fax to
--------------                       ---------
Ada-Belgium Secretariat              + 32 (0)2 650.56.09
c/o Universite' Libre de Bruxelles
Attn. Prof. R. Devillers
Boulevard du Triomphe / Triomflaan   or e-mail to
Campus de la Plaine, CP 212          ------------
B - 1050 Brussels, Belgium           ada-belgium-board@cs.kuleuven.ac.be

Personal Information
--------------------
Name  __________________________   First name  _________________________
Job title / Occupation  ________________________________________________
Company / Institution  _________________________________________________
Address  _______________________________________________________________
________________________________________________________________________
Zip code  ______________________   City  _______________________________
Country  _______________________   E-mail  _____________________________
Telephone  _____________________   Telefax  ____________________________

I want to register, free of charge, for Ada-Belgium's Ada Course
that will take place at the U.L.B. in Brussels, starting early 2001,
bi-weekly on Wednesday evenings 19:00 - 22:00.

I will attend the following sessions:       (Please tick all that apply)
-------------------------------------
___  Wed 24 Jan 2001 - Introduction to Ada - part 1
___  Wed  7 Feb 2001 - Introduction to Ada - part 2
___  Wed 21 Feb 2001 - Object-Oriented Programming in Ada - part 1
___  Wed  7 Mar 2001 - Object-Oriented Programming in Ada - part 2
___  Wed 21 Mar 2001 - Parallel Programming in Ada
___  Wed 28 Mar 2001 - Distributed Programming in Ada
     (more sessions might be scheduled)

Indication of interest (separate registration will be required later):
___   14-18 May 2001 - 6th International Conference on Reliable Software
                       Technologies - Ada-Europe'2001, Leuven, Belgium

Membership Status for 2001                        (Please tick one item)
--------------------------
___  I am an individual Ada-Belgium member
___  I am appointed contact person of a corporate Ada-Belgium member
___  I want to register as Ada-Belgium member
       (please mail or fax an Ada-Belgium membership application form
       and pay the appropriate fee)
___  I am not, nor do I want to register as, Ada-Belgium member
       (and hence am NOT entitled to the free Ada CD-ROMs and
        documention sets)

For Ada-Belgium Members Only                (Please tick all that apply)
----------------------------
___  I would like to receive a copy of the Ada and Software Engineering
       2 CD-ROM base set (November 1998)
___  I would like to receive a copy of the Ada and Software Engineering
       2 CD-ROM update 2 set (October 1999)
___  I would like to receive a copy of the documentation set of the
       Ada-Belgium'99 Seminar, theme "Ada 95 Works!"
       (as availability permits)
___  I would like to receive a copy of the documentation set of the
       Ada-Belgium'98 Seminar, theme "Concurrency & Real-Time"
       (as availability permits)

Signature  _________________________   Date  ___________________________

If you would like to have a "nicer" printout to fax or send via normal mail, this form will also be available shortly as a Microsoft Word Document.

To the Ada-Belgium home page. To the Ada Course Home Page.

Last update: 2000/11/09.