Membership Category (circle one): Corporate / Individual / Student
Postal Address (including contact person for Corporate member):
Phone:
Fax:
E-Mail:
Topics of Current Interest in Pattern Recognition:
Institution Certification of full-time enrolment (if student member):
Please print this form and return with your remittance to:
Tony Adriaansen Phone: +61 2 9372 4326 Fax: +61 2 9372 4411 email: Tony.Adriaansen@csiro.au CSIRO ICT Centre P.O. Box 76, Epping, NSW 2121, AUSTRALIA