REGISTRATION FORM

Thirteenth International Conference on Cognitive and Neural Systems

May 27–30, 2009

Boston University

Department of Cognitive and Neural Systems

677 Beacon Street

Boston, Massachusetts 02215 USA

Fax: +1 617 353 7755

Mr/Ms/Dr/Prof:_____________________________________________________

Affiliation:_________________________________________________________

Address:__________________________________________________________

City, State, Postal Code:______________________________________________

Phone and Fax:_____________________________________________________

Email:____________________________________________________________

The registration fee includes the conference proceedings, a reception on Friday night, and 3 coffee breaks each day.

CHECK ONE:

( ) $95 Conference (Regular)

( ) $65 Conference (Student)

METHOD OF PAYMENT (please fax or mail):

[ ] Enclosed is a check made payable to "Boston University"

Checks must be made payable in US dollars and issued by a US correspondent bank. Each registrant is responsible for any and all bank charges.

[ ] I wish to pay by credit card

(MasterCard, Visa, or Discover Card only)

Name as it appears on the card:___________________________________________

Type of card: _____________________________ Expiration date:________________

Account number: _______________________________________________________

Signature:____________________________________________________________