REGISTRATION/ACCOMMODATION FORM
Please
TYPE or PRINT in BLOCK LETTERS and AIRMAIL, FAX or E-mail to: Global Dimming,
Family Name ____________________________ First Name___________________________
Title: Prof Dr Mr Ms
Mailing Address ________________________________________________________________
________________________________________ Country ______________________________
Tel _____________________________________ Fax_________________________________
e-mail ________________________________________________________________________
1.
ACCOMMODATION PACKAGE* for February 10-14,
2008
Before After
January 1,
2008
Scientist Funded – no payment US$ 650 US$ 750
Student ** Funded – no payment US$ 450 US$ 500
Accompanying Person, sharing room with
Scientist or student US$ 525 US$ 575
Supplement for single room US$ 160 US$ 160
Accommodation package for scientists
is for a single room and for students for a shared twin room.
**Students and post-doc fellows
are requested to provide an official authorization of their status.
I will be sharing a room with ____________________________ who is
another participant, or a non-participant accompanying person,
I wish to share with another participant male/female.
2. TRANSFER SERVICE AND FLIGHT INFORMATION
Please complete – very important:
I will require a transfer
Arrival date
_____________ Airline/Flight ____________ at __________ hours
I will require a transfer
Departure date
__________ Airline/Flight ____________ at __________ hours
3. OPTIONAL ACCOMMODATION IN JERUSALEM- Prima Royale Hotel
Single Room Double Room
Check-in date ________________ Check-out date ________________ No. of nights ________
I will be sharing a room with _______________________________________________________
4. OPTIONAL TOURS
Pre-workshop Tour A, Nazareth, Capernaum, Sea
of Galilee, Feb. 8-9, 2008. No. of seats
________
Pre-workshop Tour B, Orientation of Jerusalem,
February 9-10, 2008. No. of seats ________
Post-workshop Transfer/Accommodation, Feb. 14-15,
2008.
Single
Double Room
5. PAYMENT DETAILS
Enclosed cheque in amount of US$_____________________ payable to Target Conferences, cheque number bank_____________________
I have made a bank transfer of US$__________________ as follows:
Bank Leumi, Branch #. 804, 87 Ben Yehuda Street, Tel Aviv, 29122, Israel to account
# 341500/08, Swift Code Lumiilit (enclose copy of transfer receipt).
Charge US$ _______to credit card Amex Diners Club Mastercard Visa
Credit Card No. _________________________________________ Expiry Date_____________
Numbers on Back of Card________________ Signature________________ Date ____________
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