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Name: ________________________________________________________________________ 
Email address: ___________________________________________________________
Conference Title:  The 21st IEEE International Symposium on Defect and Fault Tolerance in VLSI Systems (DFT'06)
Conference Dates:  October 4-6, 2006 
Conference Location:  Hilton Arlington & Towers, Arlington/Washington DC, USA
Are you an IEEE Member? Yes No If Yes, Your IEEE Member Number:_____________ 
Are you a speaker/presenter? Yes No 
Name of session you are speaking/presenting: __________________________________ 
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       City: _____________________________________________________________
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