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REGISTRATION FORM - Eurasia Conference

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REGISTRATION FORM - Eurasia Conference Powered By Docstoc
					                      INTERNATIONAL SYMPOSIUM ON
                      NATURAL PRODUCT CHEMISTRY
                                                          (ISNPC-12)
                                         November 22 - 25, 2010, Karachi, Pakistan


                                        REGISTRATION FORM
Kindly remember that this information will be used to create your name tag. Please list your name and affiliation exactly as you wish
them to appear on your tag.


Family Name________________________ First Name ________________________ Middle Name _________________________

Affiliation _________________________________________________________________________________________________

Mailing Address ____________________________________________________________________________________________

 ________________________________________________________________________________________________________

City ____________ State ___________ Country _____________ Zip ________ Phone with Country / City Code ________________

Fax ____________________ Home Phone ________________________ E-Mail ________________________________________

Name of accompanying person(s) ______________________________________________________________________________

I will be flying by
Pakistan International Airlines (PIA) _________ Other __________ Date __________ Arrival Time __________ Flight # __________

Note: Please provide flight information so that we can adequately plan for your reception and transportation at the airport.


Please check the appropriate spaces, enter all costs, and total.

                      Registration Fees:                                  Before                   After
                                                                   (September 30, 2010)     (September 30, 2010)
                                                                         (U.S. $)                 (U.S. $)
                           Scientist from Private Organization             800                      1200
                           Academic Faculty                                500                      800
                           Student                                         300                      450
                           Accompanying Person                             100                      350
                           Conference Proceeding                            60                      60
                                              Total US$


In case of cancellation before September 30, 2010, the fees will be refunded after a deduction of US $ 100. Requests for refunds must
                                                                               st
be made in writing to the address below. No cancellation will be issued after 1 October, 2010.

Return completed form with
payment to:

PROF. DR. M. IQBAL CHOUDHARY
Organizing Secretary
(International Center for Chemical and Biological Sciences            Payment options:
H. E. J. Research Institute of Chemistry
Dr. Panjwani Center for Molecular Medicine and Drug Research)             Payment enclosed (make bank draft payable to
University of Karachi,                                                       “International Symposium” A/c No. 101-2065-9, United
Karachi-75270, Pakistan                                                      Bank Limited
Phone: (92-21) 34824924, 34824925                                             Branch Code: 1146, University Campus Branch
Fax: (92-21) 4819018, 99261713
                                                                              University of Karachi-75270, Pakistan).
Email: mhej@cyber.net.pk
                         INTERNATIONAL SYMPOSIUM ON
                         NATURAL PRODUCT CHEMISTRY
                                                            (ISNPC-12)
                                            November 22 - 25, 2010, Karachi, Pakistan


                                       TOUR RESERVATION FORM

I (we) wish to register for the following tours (Tours # 4 & 5 include airfares).


  Tour # 1        Half-day tour crabbing/fishing trip                               $ 50.00 X ___________ Persons =$ _______________
                  (Every day, November 26-30, 2010)

  Tour # 2        Full-day tour/shopping trip to Metropolitan Karachi city          $ 40.00 X ___________ Persons = $ _____________
                  (Every day, November 26-30, 2010)

  Tour # 3        Day trip to Thatta (lunch included)                               $ 60.00 X ___________ Persons = $ _____________
                  (Every day, November 26-30, 2010)

  Tour # 4        Day trip to Lahore (lunch included)                               $ 450.00 X __________ Persons = $ _____________
                  (November 26, 2010)

  Tour # 5        Day trip to Islamabad & Taxila (lunch included)                   $ 600.00 X __________ Persons = $ _____________
                  (November 26, 2010)

                                                                                                    Total amount:     $ _____________


Name of person(s) to be included on this reservation: ______________________________________________________________
 ________________________________________________________________________________________________________
Your full name, address and phone number: ______________________________________________________________________
 ________________________________________________________________________________________________________
 ________________________________________________________________________________________________________

Important information: Space is limited. The Rakaposhi Tours must receive reservation request by November 10, 2010. Amount must
be paid in full in advance to Rakaposhi Tours. If there are less than ten participants, then the price will not remain the same or the tour
will be cancelled. Rates of tours # 4 & 5 are subject to change if domestic airfare is revised. There are many other tours available,
detail of which you may get in advance on request through email / fax or at the Tour Desk during the Symposium

Above tours may be operated on daily basis also on special request for delegates and the spouses.

To make your tour reservation (s), complete this form and mail directly to:

Rakaposhi Tours (Pvt) Ltd.
         st
12-C, 31 Commercial Street, Phase V
Defence Housing Authority
Karachi-75500, Pakistan
Tel: (92-21) 5864848, 5864949
Fax: (92-21) 5870652
Email: info@rakaposhi.com.pk

             or


PROF. DR. M. IQBAL CHOUDHARY                                                 Payment options:
Organizing Secretary
(International Center for Chemical and Biological Sciences
H. E. J. Research Institute of Chemistry
                                                                                Payment enclosed (make bank draft payable to
                                                                                    “International Symposium” A/c No. 101-2065-9, United
Dr. Panjwani Center for Molecular Medicine and Drug Research)
University of Karachi,                                                              Bank Limited
Karachi-75270, Pakistan                                                              Branch Code: 1146, University Campus Branch
Phone: (92-21) 34824924, 34824925                                                    University of Karachi-75270, Pakistan).
Fax: (92-21) 4819018, 99261713
Email: mhej@cyber.net.pk
                      INTERNATIONAL SYMPOSIUM ON
                      NATURAL PRODUCT CHEMISTRY
                                                         (ISNPC-12)
                                         November 22 - 25, 2010, Karachi, Pakistan


                         HOTEL ACCOMMODATION FORM
Metropolitan Karachi has many excellent as well as tourist class hotels. Hotel Sheraton, with its beautiful Moghul architecture, is
situated in the heart of the city. Hotel Marriott, another excellent hotel, is the conference venue. The deluxe Pearl Continental Hotel
Chain also has a hotel in Karachi while Hotel Avari Towers is part of the Ramada Inn chain. Apart from these deluxe hotels, moderately
priced 4 and 3 star hotels are also available in Karachi. Advance booking is necessary in all these hotels.

Family Name ________________________ First Name ________________________ Middle Name _________________________
Affiliation and Mailing Address ________________________________________________________________________________
 ________________________________________________________________________________________________________
City ____________ State ___________ Country _____________ Zip ________ Phone with Country / City Code _________________
Fax ____________________ Home Phone ________________________ E-Mail ________________________________________
Numbers of Nights to Stay ____________________________________________________________________________________

CLASS A
                       5-Star Hotels                            Approx. per night                       Distance from heart of city
      A-1              Hotel Sheraton                           US$ 250                                 (02 minute walk)
      A-2              Hotel Marriott                           US$ 250                                 (10 minute walk)
      A-3              Hotel Pearl Continental                  US$ 200                                 Venue
      A-4              Hotel Avari Towers                       US$ 120                                 (10 minute walk)

CLASS B
                       3-4-Star Hotels                          Approx. per night                       Distance from heart of city
      B-1              Hotel Regent Plaza                       US$ 120                                 (2 km)
      B-2              Hotel Metropole                          US$ 120                                 (5 minute walk)
      B-3              Hotel Carlton                            US$ 120                                 (6 km)

C L A S S C ( 1-2 Star Hotels)
                       1-2-Star Hotels                          Approx. per night                       Distance from heart of city
      C-1              Hotel Faran                              US$ 40                                  (2.5 km)
      C-2              Best Western Hotel                       US$ 60                                  (1.5 km)
      C-3              Hotel Mehran                             US$ 60                                  (10 km)

C L A S S D (Only for Foreign Graduate Students)
                                                                Approx. per night                      Distance from heart of city
 Guest Houses                                                   US$ 25                                 (5-15 km)
 University Hostel                                              US$ 10                                 (15 km)

Only limited accommodation is available and participants are therefore advised to send the completed hotel accommodation form along
with the registration fee and cheque corresponding to the number of nights they wish to stay in Karachi as soon as possible, particularly
since hotels in Karachi are very heavily booked in November. Payments should be made directly to the Secretariat either in th e form of
a bank draft in favor of (“International Symposium” A/c No. 101-2065-9, United Bank Limited, Branch Code: 1146 University Campus
Branch, University of Karachi-75270, Pakistan) or by cheque.

Return completed form with
payment to:


PROF. DR. M. IQBAL CHOUDHARY                                              Payment options:
Organizing Secretary
(International Center for Chemical and Biological Sciences                    Payment enclosed (make bank draft payable to
H. E. J. Research Institute of Chemistry                                            “International Symposium” A/c No. 101-2065-9, United
Dr. Panjwani Center for Molecular Medicine and Drug Research)                       Bank Limited
University of Karachi,                                                               Branch Code: 1146, University Campus Branch
Karachi-75270, Pakistan                                                              University of Karachi-75270, Pakistan).
Phone: (92-21) 34824924, 34824925
Fax: (92-21) 4819018, 99261713
Email: mhej@cyber.net.pk
                      INTERNATIONAL SYMPOSIUM ON
                      NATURAL PRODUCT CHEMISTRY
                                                         (ISNPC-12)
                                         November 22 - 25, 2010, Karachi, Pakistan



  REGISTRATION FORM FOR PAKISTANI PARTICIPANTS
Please remember that this information will be used to create your name tag. Please list your name and affiliation exactly as you wish
them to appear your tag.


Family Name________________________ First Name ________________________ Middle Name _________________________

Affiliation _________________________________________________________________________________________________

Mailing Address ____________________________________________________________________________________________

 ________________________________________________________________________________________________________

City ____________ State ___________ Country _____________ Zip ________ Phone with Country / City Code ________________

Fax ____________________ Home Phone ________________________ E-Mail ________________________________________

Name of accompanying person(s) ______________________________________________________________________________

I will be flying by
Pakistan International Airlines (PIA) _________ Other __________ Date __________ Arrival Time __________ Flight # __________


Please check the appropriate spaces, enter all costs, and total.

                          Registration Fees:                           Before                   After
                                                                (September 30, 2010)     (September 30, 2010)
                                                                        (Rs.)                   (Rs.)
                               Private Organization                    5,000                    10,000
                               Academic Faculty                        3,000                     6,000
                               Student                                 2,000                     4,000
                               Accompanying Person                     2,000                     4,000
                               Conference Proceedings                  3,000                     3,000
                                         Total Rs.



In case of cancellation before September 30, 2010, the fees will be refunded after a 50% deduction. Requests for refunds must be
made in writing to the address below. No cancellation will be issued after October 01, 2010.

Return completed form with
payment to:


PROF. DR. M. IQBAL CHOUDHARY
Organizing Secretary
(International Center for Chemical and Biological Sciences            Payment options:
H. E. J. Research Institute of Chemistry
Dr. Panjwani Center for Molecular Medicine and Drug Research)
University of Karachi,
                                                                          Payment enclosed (make bank draft payable to
                                                                               “International Symposium” A/c No. 101-2065-9, United
Karachi-75270, Pakistan
Phone: (92-21) 34824924, 34824925                                              Bank Limited
Fax: (92-21) 34819018, 99261713                                                 Branch Code: 1146, University Campus Branch
Email: mhej@cyber.net.pk                                                        University of Karachi-75270, Pakistan).
                  INTERNATIONAL SYMPOSIUM ON
                  NATURAL PRODUCT CHEMISTRY
                                               (ISNPC-12)
                                 November 22 - 25, 2010, Karachi, Pakistan


                          PERSONAL BIODATA FORM
                      (For Information of the Government of Islamic Republic of Pakistan)




                                                                                                   Photograph
                                                                                          Kindly enclose three passport
                                                                                                size photographs




Family Name ________________________ First Name ________________________ Middle Name _________________________


Address __________________________________________________________________________________________________


 ________________________________________________________________________________________________________


Phone (Office) _____________________________________ (Home) _________________________________________________


Email ____________________________________________ Fax ____________________________________________________


Passport No. ____________________________________ Issued on _____________________ Issued from __________________


Expired on ________________________________________________________________________________________________


Current Nationality ____________________________________________ Nationality at Birth ______________________________


Purpose of Visit ____________________________________________________________________________________________


Period of Stay _____________________________________________________________________________________________


Place of Stay in Pakistan _____________________________________________________________________________________


Name of the Inviting Agency __________________________________________________________________________________


Name and Address of the Contact Person in Pakistan ______________________________________________________________


_________________________________________________________________________________________________________
              INTERNATIONAL SYMPOSIUM ON
              NATURAL PRODUCT CHEMISTRY
                                                       (ISNPC-12)
                          October 29 to November 01, 2010, Karachi, Pakistan


                                                     ABSTRACT
To be returned before September 30, 2010 to International Center for Chemical and Biological Sciences, H. E. J. Research
Institute of Chemistry, University of Karachi, Karachi-75270, Pakistan (Email: mhej@cyber.net.pk)

                                                        Leave this space empty
                                                     Type on enclosed abstract form
                                                            Leave one line

          Title in Bold 18 Pt Times-Roman with only Initial in
                                 Capital
                                                             Leave one line
              Names of Authors (Speaker underlined) in 12 pt with only Initials in Capitals
                                                         Leave one line
                                             Postal address (including fax and email)
                                                         Leave one line

           Start text here.
           Type within the area indicated by the frame (Line spacing 1.3-1.5).
           Use preferably Times-Roman 12 pt, and a laser printer. In any case, use a good
           quality black type.
     Prepare structural formulae and drawings of moderate size, also in black (laser, Indian ink,
     or transfer, preferably). Do not use dot-matrix printers.
     An acceptable example is given below:

                                        BF3.Et2O                                                  Me
                                                                                              H
                              Me        MeSO3H                         Me
                              O         CH2Cl2, rt                     O                               O
                                           18 h
                          N        Ph                              N        Ph                    N        Ph
                    MeO                                                                       H
                          X                                        X
                 (1) X = t-Bu                                                           (3) X = t-Bu (75%)
                 (2) X = CMe2Ph                                                             X = CMe2Ph (61%)



            The abstract should give the essential features of the presentation to the participants
      and future readers, and should contain a few (at most 4 or 5) key refs., preferably in the
      style indicated below.
            You can use only one page for each lecture or poster abstract. The present model
      indicates the presentation recommended, which you can adapt to the means at your
      disposal. However, you must strictly confirm to the dimensions for the typing/drawing
      area.
            The size of the abstract must not exceed one page.
      Refs.
      1. R. Grigg, and V. Sridharan, Tetrahedron Lett., 33, 7965 (1992).

				
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