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REGISTRATION AND HOTEL RESERVATION FORM

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REGISTRATION AND HOTEL RESERVATION FORM Powered By Docstoc
					                                                   EACL03
                                      April 12-17, 2003 - Budapest, Hungary
                  REGISTRATION AND HOTEL RESERVATION FORM
 Please fax (36-1-386-9378) or mail the completed Registration Form with payment to the EACL 2003 Secretariat
   (Mariann Kindl, H-1111 Budapest, Kende u. 13-17, Hungary) as soon as possible but not later than 15 March
                           2003 if you want to benefit from the ealy registration fees.

PERSONAL DATA
Family name: ……………………..……………………………… Given name: ………………………...…………
Affiliation (for badge): …………………….………………………………………………………………………...
Address: ………………………………………………………………….…………………………………………..
Town/City: ………………………………..…………….… Zip code: …………………..………………………….
Country: ………..………………..………..…………….… E-mail: ………………………………….……………..
Phone: ………………………………..…… ………….… Fax: ……………………………………..…..………….
Please indicate if you do not wish to be included in the list of participants:
Exchange rates

A. REGISTRATION FEES

Regular registration fees
(VAT included)                                 Early                             Late
50% off for students from all fees!        before 15 March                after 15 March        Total fee

11 April - COMPLEX                           HUF 18.000                    HUF 23.000       HUF .................

12 April - TUTORIALS
morning:     1   2                          HUF 25.000                     HUF 32.000       HUF ..................
12 April - TUTORIALS
afternoon: 3     4                          HUF 25.000                     HUF 32.000       HUF ..................

TUTORIALS TOTAL                  (More about Tutorials)                                     HUF...................

13 April – 1 day WORKSHOPS
1     10      12                            HUF 18.000                     HUF 25.000       HUF ..................
14 April – morning WORKSHOP
5                                           HUF 12.000                     HUF 16.000       HUF ..................
14 April – afternoon
WORKSHOP
11                                          HUF 12.000                     HUF 16.000       HUF ..................
14 April – 1 day WORKSHOPS
4    7        8                             HUF 18.000                     HUF 25.000       HUF ..................
13-14 April - 2 days WORKSHOPS
2      3       6     9                      HUF 32.000                     HUF 44.000       HUF ..................

WORKSHOPS TOTAL                  (More about Workshops)                                     HUF ..................

15-17 April - MAIN
CONFERENCE                                  HUF 72.000                     HUF 93.000       HUF ..................
SURCHARGE for NON Main
Conference participant                                       HUF 37.000                     HUF ..................

REGULAR REGISTRATION FEES TOTAL (Complex + Tutorials + Workshops + Main Conference) HUF ..................

STUDENT FEES TOTAL (50% of the above regular registration fees total)                       HUF ..................
B. BANQUET (VAT included)
Banquet (16 April)                                              HUF 12.500            ..... persons x HUF 12.500      HUF ...................

C. LUNCHES (VAT included)
Sandwich lunch(es) for April
12        13       14       15       16       17             HUF 2.000/day/lunch       ..... lunch(es) x HUF 2.000    HUF ...................

Lunch ticket can be bought in advance for sandwich lunches (on April 12, 13, 14, 15, 16, 17) served in the
Restaurant of the Agro Hotel Conference Center. Please, indicate the days and number of tickets required on your
registration form. Each ticket costs HUF 2000/lunch. Availability of tickets on-site will be limited.

D. HOTELS
A block reservation for participants has been made in hotels below.
Room rates include breakfast and all taxes.
Hotel fee should be paid to the Local Organisers at the registration. No reservation will be made without credit
card information!

Check in date April .......... 2003 - check out date April .......... 2003.

Budai Sport Hotel***                                                                    Single room HUF              Double room HUF
15- minute walking distance from conference site.                                       13.000/night                  16.500/night
General Conditions
One night room rate will be charged
- in case of non-attendance if a cancellation notice in writing is not received by the Conference Secretariat on or
before 01 April 2003
- in case of delayed arrival if the Conference Secretariat is not advised on or before 01 April 2003

                                                                               PAYMENT                                  Amount
     I declare hereby that I am a member of ACL.
                                                                               A. Regular or student registration
     I will settle my ACL membership before the                                fee(s) total                             HUF ..................
        conference or on the spot at registration.
                                                                               B. Lunch                                 HUF ..................
I have read and accept all the conditions above.
                                                                               C. Banquet                               HUF ..................
Signature            ……………….….                                                 TOTAL AMOUNT ENCLOSED                    HUF .................
METHOD OF PAYMENT
Credit Card                                                          Bank transfer to the account:
I agree EACL03 (account no. 10032000-                                                     "EACL03" MTA SZTAKI
01738588) to charge the above amount to                                               Account no. 10032000-01738588
AmEx       EuroCard/MasterCard      Visa                                            Bank name: National Bank of Hungary
                                                                                      Bank address: H-1850 Budapest
Card number ...................................................                         Swift code: MANEHUHBA
Expiry date.......................................................
Cardholder’s name...........................................
                                                                     Please, attach a proof of the remittance to this Registration Form
CVV code (last 3 digits of the security code                         and make sure that the name of each Conference participant is
(see the back side of your card or on Amex                           clearly indicated on all documents. I have transferred the above
Cards the additional 4-digit code on the front)                      amount.
.......................
Billing address: ................................................
.......................................................................... Date …….…..………………
                                                                     .
                                                                                                     Signature ….…..…...…...………
Cardholder’s signature ....................................

				
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