The EPAC96 Registration Form

The 1996 European Particle Accelerator Conference

Gran Sitges Hotel, Sitges, Barcelona, 10 - 14th June, 1996

Registration Form

If you are using this form, your browser must be capable of handling fill-in forms (e.g. Mosaic for X, Lynx). If this form looks bizzarre on your screen, use the text form or print the postscript version. Be sure to read the instructions at the bottom of this form to ensure successful registration via this online form. Please do not submit multiple registrations for the same person.

NOTE: REGISTRATION IS NOT COMPLETE UNTIL PAYMENT OF THE FEES HAS BEEN RECEIVED.

Identification

          Title:
      First Name:
     Family Name:

   Date of birth: (Day/Month/Year)
  
     Affiliation:

Mailing Address for Conference Material


Address Line 1:
Address Line 2:
Address Line 3:
          Town:
   Postal Code:
       Country: 

        E-mail:
         Phone:
           Fax:

Accompanying Person(s)

Names of people wishing to join the social programme (Not participating in the scientific programme):
please include a carriage return after each name

Registration Fees

48000 Ptas Payment after 10th April 1996
44000 Ptas Early payment (before 11th April 1996)
42000 Ptas National Physical Society EPS member, early payment (before 11th April 1996)
40000 Ptas Individual EPS member, early payment (before 11th April 1996)
EPS Membership No:

The fee covers the cost of the Proceedings, the reception and the conference dinner.

Reception and Conference Dinner

Checking the boxes below indicates "yes".

I will attend the conference dinner "Drassanes Reials" (12th June)
(Cost included in Conference Fee for delegates)

Number of EXTRA tickets for dinner:, at a cost of 7000 Ptas per person.

Special dietary requirements:

I will attend the conference reception at the Gran Sitges Hotel (9th June)
(Cost included in Conference Fee for delegates and free of charge to accompanying persons)

Number of accompanying persons at for the reception:

Proceedings

How would you like to receive your copy of the proceedings?
Check the appropriate box
CD ROM
Paper
Number of extra copies of the CD-ROM:, at a cost of 3500 Ptas each.

Payment must be made by:

-

cheque or Bank transfer in Pesetas only (stating clearly EPAC'96 and the name of the participant) made payable to:


Caixa d'Estalvis i Pensions de Barcelona     Account: 02 00149769
Universitat Autonoma de Barcelona            Name: EPAC-UAB
Edifici del Rectorat                         Swift Code: CAIXESBBBC1
E - 08193 Bellaterra                         Bank No. 2100 Branch No. 0424

-

payment upon late registration at the conference must be in Pesetas or travellers' cheques. Personal cheques cannot be accepted for late registrations.

-

Credit cards will not be accepted.

Any cancellations, modifications, etc. must be communicated directly to the EPAC'96 Secretariat. In the case of written cancellations made before 10 April 1996, 70% of the total pre-paid amount will be refunded. No reimbursement can be made for cancellation after this date.

Check the appropriate box for your method of payment

Personal cheque
Bank transfer

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