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WWW 94
Registration Form
Identification
==============
Name: ..............................
Affiliation: ..............................
Address: ..............................
Street & number: ..............................
Country: ..............................
Postal Code: ..............................
City: ..............................
Postal District: ..............................
E-mail: ..............................
Phone: ..............................
Fax: ..............................
Name & Affiliation on badge if different from above:
..................................................
Preferred size of your free WWW T-shirt: [_] S [_] M [_] L [_] XL
[_] Special dietary requirement
[_] Require special services as disabled attendee
[_] Do not want name to appear on attendee list
Hotel Booking
=============
Please book at the hotel
Moevenpick, 100 CHF per room per night
single room [_]
double room [_]
Le Warwick, 155 CHF per room per night
single room [_]
double room [_]
for .... nights
I will arrive on ........ and depart on .........
Conference fee
==============
The complete conference registration fee includes
transportation to and from the two listed hotels,
lunch on Wednesday, Thursday and Friday, the
conference dinner on the Lake boat on Thursday
evening and the tutorials.
Normal fee
----------
Registration before April 30: [_] 500 CHF
Late registration: [_] 600CHF
Attendees from Academic Institutes
----------------------------------
Registration before April 30: [_] 400 CHF
Late registration: [_] 500 CHF
Students
--------
Registration before April 30: [_] 300 CHF
Late registration: [_] 400 CHF
Business Path only
------------------
(Thursday afternoon and dinner)
Registration before April 30: [_] 300 CHF
Late registration: [_] 400 CHF
Extra dinner tickets: .... at 80 CHF each
Method of payment
=================
[_] Cheque:
made payable to "WWW94 Conference",
account number C7-116794.0 at the
Swiss Bank Corporation, CERN-Meyrin,
CH-1211 Geneva 23, Switzerland.
Credit Card:
[_] VISA
[_] MasterCard
[_] Amexco
[_] Diners
Card number: .......................
Card expiry date: ...........
I authorise to charge my account for the fees
indicated above.
Signature: .....................
Send to:
WWW94
c/o Anne Perrelle
CERN
CH - 1211 Geneva 23
(Switzerland)
Telephone: +41 22 767 5005 Fax: +41 22 767 8730
e-mail: www1@www1.cern.ch
RC 19 Feb 94
WWW94 -- Registration Form