I will participate in the

  12th International Symposium on High-Energy Physics
  workshop on Polarized electron sources and low-energy polarimeters
  workshop on High-energy electron polarimeters 


I plan to submit (before June 15, 1996) a contribution to the

  12th International Symposium on High-Energy Physics
title: 
 
  workshop on Polarized electron sources and low-energy polarimeters
title: 
 
  workshop on High-energy electron polarimeters   
title: 
 

I will attend the Symposium dinner:
 
   with  persons

  I am interested in attending the Student Introductory Course



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

 
The hotel reservation for the Symposium is arranged via Wagon-Lits. 

Please fill the hotel reservation form, which is available as a 
HOTEL RESERVATION POSTSCRIPT FILE 

However, for persons attending (one of) the workshops (even if also attending
the Symposium) accomodation is to be made through the secretariat. 

I am attending (one of) the workshops (and the Symposium) and would like
hotel accomodation in a:
  single room
  double room (if sharing with other participant, name: )
Arrival:       Departure: 
 
Besides, the above options a limited number of rooms in student dormitories
is available.

I am interested in accomodation in a student dormitory or a room in CASA-400
  student dormitory
  CASA-400
  single
  double room (if sharing with other participant, name: )
  I am willing to share a room with another participant
Arrival:       Departure: 


Payment Form

 
The fee is Dfl 800 (Dfl 750 if received by us before July 1st, 1996),
for Ph.D. students the fee is Dfl 400 (Dfl 350 if received before July
1st, 1996).
The fee for the Workshop on Polarized Electron Sources and Low-Energy
Polarimeters is Dfl 200; the fee for the Workshop on High-Energy
Polarimeters is Dfl 100.

Dfl  (Symposium fee)
Dfl  (Fee for workshop on Polarized electron sources, etc.) 
Dfl  (Fee for workshop on High-Energy Polarimeters)
Dfl  (Symposium dinner, Dfl 50 per person)
_____________________________
Dfl  (total)


The fee will be paid in Dutch Guilders by means of


  Bank transfer (cost for sender) to Foundation Computing and Physics,
 Kruislaan 409, 1098 SJ Amsterdam, The Netherlands
 Account number 6065672 at Postbank, The Netherlands
 Please make sure that participant's name is indicated on bank transfer!!
 
 Money order (cost for sender) payable to Foundation Computing and Physics
 Kruislaan 409, 1098 SJ Amsterdam, The Netherlands
 Please make sure that participant's name is indicated on money order!!
 
 Eurocheques (with a maximum of Dfl 300 per cheque) to:
 Foundation Computing and Physics, Amsterdam.
 Please sign your cardnumber on the backside as well.
 
 Credit card.
 In this case you have to print the payment form, available as 
PAYMENT POSTSCRIPT FILE and to fax or sent it by mail).