 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
EUROPEAN PHYSICAL SOCIETY
17th INTERNATIONAL NUCLEAR PHYSICS
DIVISIONAL CONFERENCE
JANUARY 14-18, 2002 - EILAT, ISRAEL
An ASCII version of this form can be found here.
| Surname | |
| First Name | |
| Title: | Dr. Prof. Mr. Mrs. Ms. |
| Mailing Address: | |
| Country | Postal code |
|
Tel:
|
|
| Fax: | |
| e-mail: | |
| Accompanying person(s) | |
| Conference Dinner, 17/01/02 (optional) (US$ 45). Number of seats | |
| Arrival date Flight no. Time |
|
| Registration fee: | Participant (before 20 November 2001, US$250) |
| Participant (after 20 November 2001, US$290) | |
| Accompanying person, US$120 | |
| Non-member participant (before November 20, 2001), US$290 |
|
| Non-member participant (after November 20, 2001), US$330 |
|
| 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 will mail a check for US$
(or equivalent) payable to: Nuclear Physics /UNITOURS
Check No: Bank
I will mail or fax 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
I wish to charge my credit card and will airmail or fax the authorization.
Secretariat, Nuclear Physics
P.O.Box 3190, 61031 Tel Aviv, Israel
FAX: +972-3-5239299
e-mail: meetings@unitours.co.il