1999 ILLINOIS NUMBER THEORY CONFERENCE

                       SEPTEMBER 17-18, 1999

                          REGISTRATION FORM

To register for the conference, either print out a hard copy of
this form and mail the completed form to Professor A.J. Hildebrand,
University of Illinois, Department of Mathematics, 1409 West Green
St., Urbana, IL 61801, or download the form (using the save button
on your web browser) and send the completed form via email to
ajh@uiuc.edu. 


Name:

Institution:

Email:


Mailing address:







----------------------------------------------------------------
If you are interested in giving a 20 minute contributed talk,
please provide a title and an abstract.  Note that the space for
contributed talks is limited, and we may not be able to accommodate
all requests for talks.  The deadline for requesting a slot for a
contributed talk is August 15, 1999.

Title of talk:




Abstract (2 or 3 sentences, in plain text or TeX):










Remarks: