ICHMT International Symposium on Transient Convective Heat and Mass Transfer in Single and Two-Phase Flows
17 – 22 August 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 Cesme Golden Dolphin Hotel: _____ 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 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 Izmir Airport to Golden Dolphin Hotel [ ] From Golden Dolphin Hotel to Izmir Airport
Arrival Date : ____________________ Departure Date : ____________________
Arrival Time : ____________________ Departure Time : ____________________
Flight No : _______________________ Flight No : _________________________
From : __________________________ To: _______________________________
(last point of departure) (first destination)
Number in the 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 preferably before July 1, 2003