EPAC'96
Fifth European Particle Accelerator Conference
Gran Sitges Hotel, Sitges (Barcelona)
10-14 June 1996
CONFERENCE REGISTRATION FORM
(Please note that payment must accompany this form)
_____________________________________________________________
Please type or print
DELEGATE DATA
Family Name	.......................	First Name	....................	Initials   ........
Title (Prof./ Dr./ Mr./ Mrs./ Ms)	...................	Date of Birth	...................

Affiliation .......................................................................................

Mailing Address	...................................................................................

	...........................................................................................

	...........................................................................................

Town	.........................    Postal Code  .................  Country    ...................

Tel. no. ........................    Fax no.  .................	E-mail	...........................

NAME(S) OF ACCOMPANYING PERSON(S) (Not participating in the Scientific Programme)

Family Name	.......................	First Name	....................	Initials   ........

...................................................................................................

REGISTRATION FEE (Please tick boxes)
IF PAID ON OR BEFORE 10 APRIL 1996	EPS Membership No	..............................
Registration Fee	                                       O 	PTA 44.000
EPS Member (National Physical Society Member)		       O	PTA 42.000
Individual Ordinary Member of the European Physical Society    O	PTA 40.000
IF PAID AFTER 10 APRIL 1996	Late Registration Fee	       O	PTA 48.000

Please note that payment for registration at the Conference can only be made in cash or traveller's
cheques. 

OECEPTION AND CONFERENCE DINNER (Please tick boxes)
I will attend:
*	Conference Dinner "Drassanes Reials" (12 June 1996)
	(Cost included in Conference Fee for delegates)

	I will be accompanied       O Yes	O No

							No of EXTRA			Total
							Tickets				Amount

	Accompanying person (s) at PTA 7.000 each	.................	PTA ...............

Special Dietary Requirements ......................................................................

*	Reception at the Gran Sitges Hotel (9 June 1996)
	(Cost included in Conference Fee for delegates and free of charge to accompanying persons)

	I will attend the Reception	O Yes	O No

	accompanied by (number of persons):	..............

CONFERENCE PROCEEDINGS (Please tick boxes)

The cost of the conference proceedings is included in the registration fee.  Please tick your 
preference for a Book Copy or a CD-ROM:

	I prefer:	O Book Copy	O CD-ROM

Extra copies of the CD-ROM may be purchased as follows:

	No. of CD-ROM .................	at PTA 3.500	PTA .....................

					SUM TOTAL	PTA......................

METHOD OF PAYMENT (Please tick boxes)

Payment must be made either by bank transfer, cheque or banker's draft:

O	Cheque or banker's draft in Pesetas (stating clearly name of participant on reverse side) 
        made payable to UAB-EPAC

O	Bank transfer in Pesetas (stating clearly name of participant on reverse side).  Transfer 
        should be made to:

Caixa d'Estalvis i Pensions de Barcelona
Swift Code:  CAIXESBBBCI
Account no. 02 00149769
Name:  UAB-EPAC	Address:
Edifici del Rectorat
Universitat Autonoma de Barcelona
E - 08193 Bellaterra, Spain


Please send your Registration Form, together with your payment (Bank draft/Cheque) or 
copy of your Bank transfer, to:


EPAC'96 Secretariat
Synchrotron Laboratory
Vila Universitaria G-002
E - 08193 Bellaterra, Spain




Date ......................	Signature .........................................................