CBMTS-Industry VI

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

Dubrovnik, Croatia
5 through 10 April 2009
with a very important Pre-Congress Workshop on 4/5 April

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:
CBMTS Industry VI participants will be accommodated at the CBMTS venue: Hotel Croatia in Cavtat, a suburb of Dubrovnik. When Hotel Croatia is fully booked, CBMTS will assist in assigning other near-by Hotels in Cavtat.

Hotel Fees:

Room Type	Room Rate
Double Room (DR) with Single Occupancy (SO) and breakfast	EURO 105.00 daily
Double Room (DR) with Double Occupancy (DO) and breakfast	EURO 120.00 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 January 2009	After 14 January 2009
		Euro 750	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:

(Upon completion send by e-mail to ASA: CBMTS@asanltr.com and Croatian Organizing Committee: slavkobokan@hotmail.com and zvonko.orehovec@zg.t-com.hr or fax : ASA at 1-808-432-9670 or mail: ASA, PO Box 6409, Kaneohe, Hawaii 96744 USA)

The Registration Form is also availible in .doc and .pdf files

Back to CBMTS page

Back to ASA home page

Updated by Evan Saunders, 31 July 2008