(Upon completion send by e-mail to ASA: CBMTS@asanltr.com and Croatian Organizing Committee: slavko.bokan@morh.hr and zvonko.orehovec@morh.hr or fax : ASA at 1-808-432-9670 and Croatian Organizing Committee: 385-1-378-6700 or mail: ASA, PO Box 6409, Kaneohe, Hawaii 96744 USA and Croatian Organizing Committee, MOD M-1, Defense Policy and Planning Depart., Illica 256b, HR-10000, Zagreb, Croatia)

Registration Form for:

The 14th meeting in the CBMTS series:

CBMTS-Industry V

"Fourth World Congress on Chemical, Biological and Radiological Terrorism"

Dubrovnik, Croatia
15 through 20 April 2007
with a very, very important Pre-Congress Workshop on 14/15 April on considerations across the spectrum of dual use and non-proliferation
and the
10th Anniversary of the OPCW

Personal Information:
Family Name:
First Name(s):
Title / Profession:
Organization / Company:
Postal Mailing Address:
Phone:	Fax:
E-mail address:
Accompanying Person:	Relationship:

NOTES:

Abstract Title:
Abstract has been sent: (give date)	or will be sent: (give date)

Accommodation Request:
The Hotel Croatia, a five-star hotel, sits on the Adriatic. We plan to have all participants stay at the Hotel Croatia with these very special prices. Ms Nina Dumancic, our board member and Travel Advisor, informs us that 70% of these rooms have sea views and these of course are on a first reserved basis.

Hotel Fees:

Room Type	Room Rate
Single room with breakfast	EURO 85.00 daily
Double room with breakfast	EURO 102.00 daily

Room Preference:	Single	Double
Dates:

Travel Info:
Flight Arrival to CBMTS (date/ time):	Airline/Flight Number:
Flight Departure (date/ time):	Airline/Flight Number:

Registration Fees and Payment:
Registration Fee:		Before 15 February 2007	After 14 February 2007
		Euro 730	Euro 800
Registration:
Hotel Deposit: Euro 85. Note: When registration is provided - hotel deposit is not required.
Total Registration and Hotel Deposit:
*Credit Card Type:	Credit Card Number:			Expiration Date(MM/YY):

Name on Card:
Signature:

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Updated by Evan Saunders, 26 December 2006