Please email this form to:	danield@w3.org and copy
				ramfos@sophia.inria.fr

***Subject line should read:  WAI May 22, 1997 WG Meeting***

First Name:
Last Name:
Title:
Company:
Address:
Address2:
City:
State:
Zip:
Country:
Email:
Phone:
Fax:
URL:

Meals
____  Vegetarian

____  Diabetic

***Special Services - Very Important***

Special Services will be available upon request.  
Requests will be confirmed separately by the meeting coordinator.

Sign Language Interpreter: (check one)

____ French Sign Language

____ American Sign Language

____ Gestuno

____ None

Assistive Lisetning Device:

____ Cocklear

____ Headset

____ Neckloop

____ None

Adapted Program:

____ Braille Program

____ Large Print Program

____ Disk (ASCII)

____ None