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 in the fall of 1998,
bi-weekly on Wednesday evenings 19:00 - 22:00.

I will attend the following sessions:       (Please tick all that apply)
-------------------------------------
___  Wed 23 Sep 1998 - Introduction to Ada - part 1
___  Wed  7 Oct 1998 - Introduction to Ada - part 2
___  Wed 21 Oct 1998 - Object-Oriented Programming in Ada - part 1
___  Wed  4 Nov 1998 - Object-Oriented Programming in Ada - part 2
___  Wed 18 Nov 1998 - Parallel Programming in Ada
___  Wed 16 Dec 1998 - Distributed Programming in Ada
     (more sessions will be scheduled in 1999)

Indication of interest (separate registration is required):
___  Fri  4 Dec 1998 - 8th Annual Ada-Belgium Seminar
       (full day event, theme: parallelism, tasking, real-time, etc.)

Membership Status for 1998                        (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 set)

For Ada-Belgium Members Only                (Please tick all that apply)
----------------------------
___  I would like to receive a copy of the Walnut Creek Ada CD-ROM set
       (latest edition, i.e. April 1998)
___  I would like to receive a copy of the documentation set of the
       Ada-Belgium'97 Seminar on Developing Distributed Applications
       (as availability permits)
___  I would like to receive a copy of the Ada-Tour CD-ROM that was
       handed out at the Ada-Belgium'97 Seminar (release 2.0i, as
       availability permits)

Signature  _________________________   Date  ___________________________

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

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

Last update: 1998/11/24.