International Conference on Applied Mathematics
                 in memory of

       Ralph Ellis Kleinman (1928-1998)

         Advanced registration form  

   Please submit before October 15, 1998.

  Name __________________________________

  Email address ________________________________

  Address ______________________________________
          ______________________________________
          ______________________________________

  Telephone_____________________________________
  FAX___________________________________________

  Arrival Date__________________________________
  Departure Date________________________________

  Reception on November 6, 1998   Yes / No (how many)
  Banquet on November 7, 1998     Yes / No (how many)

  Please send the completed form to Ms. Ginger Moore.

   email: ginger@math.udel.edu
   regular mail: Ms. Ginger Moore
                 Department of Mathematical Sciences
                 University of Delaware
                 501 Ewing Hall
                 Newark, DE 19712, USA
   fax: attn Ginger Moore
        302-831-4511