EXP | EMLG98

EMLG98 - Physics of Liquids: Foundations, Highlights, Challenges

Murau, Austria, September 11-16, 1998

Registration Form

Personal information

      Name: ..............................................

   Address: ..............................................

            ..............................................

            ..............................................

            ..............................................

     Email: ..............................................

     Phone: .................... Fax: ....................

     Title: ....................            Student: .....

   Number of accompanying persons: .....
Transportation 
   I want to make use of the bus transfer

   from Vienna Airport to Murau (September 11, 1998): .....

                    and/or back (September 16, 1998): .....
Conference fees (check as applicable) 
   Conference fee (ATS 2200/2500 before/after June 1, 1998):         ATS .....

   Accompanying person(s) (ATS 1200/1400 before/after June 1, 1998): ATS .....

   Student fee (ATS 1200/1400 before/after June 1, 1998):            ATS .....
Accomodation (all meals are included in this price) 
   If sharing a room, include person's name: ....................

   Arrival date: ............... Departure date: ...............

   Single room (ATS 900 per person/night) for .... nights:           ATS .....

   Double room (ATS 850 per person/night) for .... nights:           ATS .....
Total fees 
   Sum of the above:                                                 ATS .....

Method of payment

Your payment, in full, must accompany your registration form. Fax registration must be accompanied by credit card payment information. Credit card charges cannot be processed without signature and expiration date. 
   Credit card: Diners Club ....     Mastercard ....     VISA ....

   Cardholder's name: .....................

   Card no: |_|_|_|_| |_|_|_|_| |_|_|_|_| |_|_|_|_|   Exp. date (mm/yy): ../..


   Signature: ....................
Please send the completed registration form to:
Prof. H. A. Posch
Institute of Experimental Physics
University of Vienna
Boltzmanngasse 5
A-1090 Vienna, Austria

Fax: +43-1-3102683
Phone: +43-1-31367-3109
Email: posch@ls.exp.univie.ac.at

Last modified: 17 January 1998 (MN)