=========================================================================== REGISTRATION AND ACCOMMODATION FORMS =========================================================================== Please type or fill out in BLOCK letters and mail to: JENC6 - May 1995 c/o International Travel & Congresses Ltd. P.O. Box 29313, 61292 Tel Aviv, Israel Tel: + 972-3-5102538; Fax: + 972-3-5160604 E-mail: register@jenc6.ac.il Payments should be made in US Dollars only. All costs of bank transfers to be paid by the transmitter. Please state JENC6 and your name on all payments. ------------------------------------------------------------------------ CONFERENCE REGISTRATION FEE(S): Early Registration (Before March 30) ECU 425 USD 520 USD _____ Late Registration (March 30 - May 11)ECU 475 USD 580 USD _____ Desk Registration (from May 14) ECU 525 USD 640 USD _____ Accompanying Person(s) (Includes Opening Reception, Gala Dinner and Jerusalem Tour) ECU 75 USD 92 USD _____ Tutorial (Pre/Desk) ECU 205/246 USD 250/300 USD _____ TOTAL AMOUNT TO BE CHARGED: USD _____ Name ___________________________________________________________________ Last First Middle Initial Title Full Mailing Address ________________________________________________________________________ ________________________________________________________________________ Country Telephone Fax E-mail ________________________________________________________________________ Jerusalem Tour (please select): Wednesday AM __ Thursday* PM __ * Would you require a lunch box (USD 12.-) please select: YES/NO Do you have a special meal request?_____________________________________ For Israeli participants: Payments to be made according to "Shaar Yatsig" on day of payment. METHOD OF PAYMENT: [] Visa [] AMEX [] Diners Club Date of Expiry ________________ Cardholder's name ______________________ Account no: 410977, Israel Discount Bank, Branch 100, 4 Rothschild Boulevard 66881 Tel Aviv, Israel Date ___________________________ Signature _____________________________ ------------------------------------------------------------------------ ------------------------------------------------------------------------ ACCOMMODATION & TOURS RESERVATION: Name ___________________________________________________________________ Last First Middle Initial Title Full Mailing Address ________________________________________________________________________ ________________________________________________________________________ Country Telephone Fax E-mail ________________________________________________________________________ I will share a room with _______________________________________________ Accommodation: A deposit of 1 night hotel accommodation is required in order to guarantee your reservation single double (p/p) Dan Panorama Tel Aviv (Deluxe) USD 134 USD 77 Dan Panorama Tel Aviv (Regular) USD 104 USD 62 Metropolitan USD 75 USD 46 City USD 69 USD 44 Arrival Date:_______ Departure Date:_______ No of nights:______________ Optional Pre/Post conference tours: USD 100.- deposit per person for post conference tours. Full pre-payment for pre-conference tour. USD 25.- deposit for Dinner/Entertainment single double p/p Pre-conference tour A Metropolitan USD 310 USD 241 Dan Panorama USD 339 USD 257 Post-conference tour B First Class hotel USD 383 USD 311 Deluxe hotel USD 510 USD 402 Post-conference tour C USD 235 USD 196 Tour D USD 22 (no hotel) Tour E USD 59 (no hotel) Tour F USD 53 (no hotel) Dinner/Entertainment USD 55 (no hotel) TOTAL Accommodation & Tours USD ____________ Deposit USD ____________ Balance Due USD ____________ Do you have a special accommodation/meal request?____________________ For Israeli participants: Payments to be made according to "Shaar Yatsig" on day of payment. METHOD OF PAYMENT: ____________________________________________________________________ [] Visa [] AMEX [] Diners Club Date of Expiry ________________ Cardholder's name __________________ Account no: 396699, Israel Discount Bank, Branch 100, 4 Rothschild Boulevard 66881 Tel Aviv, Israel Date _____________________________ Signature _______________________