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<html>
<head>
<title>Register for Reflections | Projections</title>
<meta http-equiv="Content-Type" content="text/html;">
<meta name="author" content="Shahrukh Syed">
<meta name="description" content="Reflections | Projections 2002 is the Annual Student Computing Conference sponsored by the University of Illinois chapter of the Association for Computing Machinery.">
<meta name="keywords" content="ACM, Association for Computing Machinery, conferences, jobs, resume, recruiting, software, hardware, developers">
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<style>
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<div id="Layer1" style="position:absolute; width:650px; height:361px; z-index:1; left: 57px; top: 160px">
<H2>Reflections Projections 2002 Attendee Registration</H2>
<form method="post" action="preregconfirm.php"
enctype="application/x-www-form-urlencoded">
<INPUT TYPE="hidden" NAME="Subject" VALUE="confreg">
<table>
<tr>
<td align="right"><font size="-1">First Name </td>
<td><input type="text" name="firstname" size="29"
maxlength="29" value="" required=true></td></tr>
<tr>
<td align="right"><font size="-1">Last Name </td>
<td><input type="text" name="lastname" size="29"
maxlength="29" value="" required=true></td></tr>
<tr>
<td align="right"><font size="-1">School/Organization</td>
<td><input type="text" name="school" value=""
size="30" maxlength="30"></td></tr>
<tr>
<td align="right"><font size="-1">Address 1 </td>
<td><input type="text" desc="address1"
name="address1" value="" required=true size="30"
maxlength="30"></td></tr>
<tr>
<td align="right"><font size="-1">Address 2 </td>
<td><input type="text" name="address2" value=""
size="30" maxlength="30"></td></tr>
<tr>
<td align="right"><font size="-1">City </td>
<td><input type="text" name="city" value=""
required=true size="30" maxlength="30"></td></tr>
<tr>
<td align="right"><font size="-1">State/Province</td>
<td><select name="state">
<option value="0">Select State or Province</option>
<OPTION value=4 id=AL>Alabama - AL</option>
<OPTION value=5 id=AK>Alaska - AK</option>
<OPTION value=6 id=AZ>Arizona -AZ</option>
<OPTION value=7 id=AR>Arkansas - AR</option>
<OPTION value=8 id=CA>California - CA</option>
<OPTION value=9 id=CO>Colorado - CO</option>
<OPTION value=10 id=CT>Connecticut - CT</option>
<OPTION value=11 id=DE>Delaware -DE</option>
<OPTION value=12 id=DC>District of Columbia - DC</option>
<OPTION value=13 id=FL>Florida - FL</option>
<OPTION value=14 id=GA>Georgia - GA</option>
<OPTION value=15 id=HI>Hawaii - HI</option>
<OPTION value=16 id=ID>Idaho - ID</option>
<OPTION
value=17 id=IL>Illinois - IL</option>
<OPTION value=18
id=IN>Indiana - IN</option>
<OPTION value=19 id=IA>Iowa -
IA</option>
<OPTION value=20 id=KS>Kansas - KS</option>
<OPTION
value=21 id=KY>Kentucky - KY</option>
<OPTION value=22
id=LA>Louisiana - LA</option>
<OPTION value=23 id=ME>Maine -
<OPTION value=24 id=MD>Maryland -
MD</option>
<OPTION value=25 id=MA>Massachusetts -
MA</option>
<OPTION value=26 id=MI>Michigan -
MI</option>
<OPTION value=27 id=MN>Minnesota -
MN</option>
<OPTION value=28 id=MS>Mississippi -
MS</option>
<OPTION value=29 id=MO>Missouri -
MO</option>
<OPTION value=30 id=MT>Montana - MT</option>
<OPTION
value=31 id=NE>Nebraska - NE</option>
<OPTION value=32
id=NV>Nevada - NV</option>
<OPTION value=33 id=NH>New Hampshire
- NH</option>
<OPTION value=34 id=NJ>New Jersey -
NJ</option>
<OPTION value=35 id=NM>New Mexico -
NM</option>
<OPTION value=36 id=NY>New York -
NY</option>
<OPTION value=37 id=NC>North Carolina -
NC</option>
<OPTION value=38 id=ND>North Dakota -
ND</option>
<OPTION value=39 id=OH>Ohio - OH</option>
<OPTION
value=40 id=OK>Oklahoma - OK</option>
<OPTION value=41
id=OR>Oregon - OR</option><OPTION value=92 id=PW>Palau -
PW</option><OPTION value=42 id=PA>Pennsylvania -
PA</option>
<OPTION value=43 id=RI>Rhode Island -
RI</option>
<OPTION value=44 id=SC>South Carolina -
SC</option>
<OPTION value=45 id=SD>South Dakota -
SD</option>
<OPTION value=46 id=TN>Tennessee -
TN</option>
<OPTION value=47 id=TX>Texas - TX</option>
<OPTION
id=UT>Utah - UT</option>
<OPTION value=49 id=VT>Vermont -
VT</option>
<OPTION value=50 id=VA>Virginia -
VA</option>
<OPTION value=51 id=WA>Washington -
WA</option>
<OPTION value=52 id=WV>West Virginia -
WV</option>
<OPTION value=53 id=WI>Wisconsin -
WI</option>
<OPTION value=54 id=WY>Wyoming - WY</option>
</select></td>
</tr>
<tr>
<td align="right"><font size="-1">Zip Code </td>
<td><input type="text" name="zip" value=""
size="10" maxlength="10"><font size="-2"></td></tr>
</tr>
<tr>
<td align="right"><font size="-1">Telephone </td>
<td><input type="text" name="phone" value=""
size="20" maxlength="20"></td></tr>
<tr>
<td align="right"><font size="-1">Email </td>
<td><input type="text" name="email" value=""
required=true size="30" maxlength="45"></td></tr>
</table>
</blockquote>
<P><INPUT TYPE="submit" VALUE="Submit">
<BR><INPUT TYPE="reset" VALUE="Clear the form">
</FORM>
<P>
</div>
<table border="0" cellpadding="0" cellspacing="0" width="800">
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