ICHMT International Symposium on Turbulence, Heat and Mass Transfer, 12 – 17 October 2003

REGISTRATION AND ROOM RESERVATION

Family Name: ________________________________        Other Names: ______________________________________________

Affiliation and Address:         _________________________________________________________________________________

                                                _________________________________________________________________________________

Tel: ____________________                 Fax: ____________________                E-Mail: __________________________________

[   ] Accompanied by Spouse and   ____  children aged  _____

Room Request in Dedeman: _____ nights   from:       /     / 2003     to:       /     / 2003

    [   ]  Single Rm                    [   ]  Double Rm                      [   ]  Triple Rm

                                                [   ]  Shared by family             [   ]  Shared by another participant(s)

Full name of the other participant(s) if you have a preference:  ________________________________________

Date: ______________________________

                                                                                                                |

Registration fee                                                               $ ______         |   [   ] I enclose a bank check payable to Faruk Arinc; or

                                                                                                                |

Accommodation (____ nights x US$ ______ = )            $ ______        |   [   ] I enclose a copy of the bank transfer document; or

                                                                                                                |

      Total                                                                          $ ______        |   [   ] Please charge my credit card for the above total amount

                                                                                                                |

CREDIT CARD PAYMENT

Please charge   ________   US Dollars to my                         [    ] Visa                 [    ] MasterCard                     [    ] Eurocard

Card Number: __ __ __ __  __ __ __ __  __ __ __ __  __ __ __ __

Expiry Date   : ___________________________

Signature : _____________________                    Date: _____________________

Name as shown on Credit Card: ________________________________________

TRAVEL SCHEDULE

Family Name: ________________________________                        Other Names: ______________________________________

I request transportation

                [   ] From Antalya Airport  to Dedeman                                                [    ] From Dedeman to Antalya Airport

                Arrival Date : ____________________                                                 Departure Date : ____________________

                Arrival Time : ____________________                                                Departure Time : ____________________

                Flight No : _______________________                                                Flight No : _________________________

                From : __________________________                                                                To: _______________________________

             (last point of departure)                                                                                  (first destination)

Number in party : ________

Name(s) of accompanying person(s) : ____________________________________________________________________

(This form is to be filled out and sent to ICHMT Secretariat by fax (+90-312-210 1331), email <arinc@ichmt.org>, or snail mail.)