Personal Information:
Family Name:
First Name(s):
Title / Profession:
Organization / Company:
Postal Mailing Address:
Phone: Fax:
E-mail address:
Accompanying Person: Relationship:
**Accompanied person fees for lunches, dinners, Welcome Party and Symposium Dinner: (will be supplied)
Abstract Title:
Abstract has been sent: (give date) or will be sent: (give date)
Accommodation Request:
Hotel Requested: Room Preference:
Dates:
Travel Info:
Flight Arrival to CBMTS VI(date/ time): Airline/Flight Number:
Flight Departure
(date/ time): Airline/Flight Number:
Note: Railroad schedules - at least every hour to Spiez/Interlacken from all airports.
Registration Fees and Payment:
Registration Fee: |
Gov/Academia registration fee: |
Industry registration fee: |
Until 24 Feb.2006 |
CHF 950 |
CHF 1250 |
After 24 Feb. 2006 |
CHF 1150 |
CHF 1450 |
Terms of Payment for Registration Fees and /or Hotel Deposit:
Credit Card Type:
Credit Card Number: Expiration Date:
Name on Card:
Electronic Transfer: Send to and mark for CBMTS VI:
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Last update: 26 October 2005