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Eilat, Israel, January 14 - 18, 2002.
REGISTRATION AND ACCOMMODATION FORM
Please return by e-mail, airmail or fax to:
Secretariat, Nuclear Physics
P.O.Box 3190, 61031 Tel Aviv, Israel
FAX: +972-3-5239299
e-mail: meetings@unitours.co.il
| Surname _________________________ First name _________________________ |
| Title: __Prof. __Dr. __Mr. __Mrs. __Ms __ __________________________ |
| Mailing address ______________________________________________________ |
| ___________________________________________________________________ |
| Country ________________________ Postal code _______________ |
| Tel. _________________ FAX _________________ |
| e-mail ____________________________________________________________ |
| Accompanying person(s) _____________________________________________ |
| __ Conference Dinner, 17/01 (optional) (US$ 45). Number of seats _______ |
| Arrival date ____________________ Flight no. __________ Time ________ |
| Registration fee: | Participant (before 20 November 2001, US$250) __________ |
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Participant (after 20 November 2001, US$290) __________
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Accompanying person, US$120 __________
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| Non-member participant (before November 20, 2001), US$290 __________ |
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| Non-member participant (after November 20, 2001), US$330 __________ |
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| Student participant, US$200 __________________ |
HOTEL ACCOMMODATION
(must be accompanied by deposit of US$110 per room)
Paradise Club Hotel in Eilat
| __ Twin room (sharing with _____________________) |
| __ Double room (sharing with ______________________) |
| __ Single room |
| Check in _______________ Check out ______________ No. of nights ____ |
PRE-CONFERENCE TEL AVIV ACCOMMODATION
(must be accompanied by full payment)
Metropolitan Hotel, Tel Aviv
| __ Twin room (sharing with _____________________) |
| __ Double room (sharing with ______________________) |
| __ Single room |
| Check in _______________ Check out ______________ No. of nights ____ |
TOURS
Please reserve the following tour(s):
| __ Tour A - Petra. Number of seats _______ (accompanied by full payment) |
| __ Tour B - Massada and the Dead Sea _______ (accompanied by US$ 100 per person) |
TRANSPORTATION
(must be accompanied by full payment upon registration)
Option: __ Number of seats _______
PAYMENT
| __ I enclose herewith US$_________ (or equivalent) payable to: Nuclear Physics /UNITOURS |
| Check No:_________________Bank___________________ |
| __ Enclosed is a copy of my bank transfer of US$_________________ |
| payable to: | Nuclear Physics - Unitours |
| Acc. No. 403575/60, Bank Leumi Le'Israel, | |
| Trumpeldor Branch (807), Tel Aviv, Israel |
| __ Please charge the amount of US$_____________ to my credit card: |
| __ American Express __ Visa/Diners Club __ Master Card |
| Credit card #______________________Expiry date____________ |
| Surname__________________________Name__________________ |
| Signature___________________________Date__________________ |