PHOTON'97 Registration Form


Name/title:        
institute:         
street nr, or POB: 
Postal code, city: 
Country:           
telephone:         
fax:               
e-mail:            


I would like hotel accommodation for myself and  accompanying persons in a:
  single room
  double room 
(if sharing with other participant, name: )
Arrival:                  
Departure:          
Means of transport: 
 I am interested in using a shuttle bus from the airport to the hotel,
cost appr. 25 NLG.
I plan to submit (before March 14, 1997) a contribution to the PHOTON'97 conference,
title:
I will attend the conference dinner with persons (including myself). The price per accompanying person is 60 NLG, there is no charge for participants. 


Payment Form


 
The fee is  600 NLG (550 NLG if payed before March 10, 1997)

(See Dutch Teletext for the exchange rates)


NLG   (Conference fee)




The fee will be paid in Dutch Guilders by means of




 Bank transfer (cost for sender) to St. Conferenties/Photon97/J.Konijn  

 Account number 37.99.16.118 RABO Bank, Soest, The Netherlands

 Please indicate participant's name clearly !!

 
 Money order (cost for sender) payable to St. Conferenties/Photon97/J.Konijn

 Account number 37.99.16.118 RABO Bank, Soest, The Netherlands 

 Please indicate participant's name clearly !!

 
 Eurocheques (with a maximum of NLG 300 per cheque) to:

 St. Conferenties/Photon97, the account given above.

 Please sign your cardnumber on the back as well.

 
 Cash at the registration desk in NLG (no credit cards accepted).
Please add any comments:
Please return this form directly through automated email: 


If you can't reply from WWW, you might use the ps-files and send the 
information by fax or by e-mail to
Mrs. Fransje Backerra at the conference secretariat:

photon97@nikhef.nl
Fax: +31 20 592 5054

PHOTON'97
c/o Fransje Backerra
NIKHEF, P.O. Box 41882
NL-1009 DB Amsterdam, the Netherlands
Tel: +31 20 592 5136