Participant	Mr. Mrs. Ms. Dr. Prof.
Name	:
Surname	:
Company	:
Address	:
Telephone	:
Fax	:
e-mail	:
Accompanying Person (s) not entitled to attend the Scientific Programme
Name	:
Surname	:
Name	:
Surname	:

Registration Fee
	Before June 10, 2002	After June 10, 2002
Full Rate	400 USD	450 USD
Author	250 USD	300 USD
Student (with photocopy of student identity card)	150 USD	150 USD
Accompanying person	150 USD	200 USD
Short Course Registration	100 USD	100 USD
Total	USD

Payment

Credit Card Visa Mastercard
Card Holder	:
Card Number	:
Expiry Date	:
I hereby authorise Kubaba Tourism Travel Agency to debit the total amount of the services booked by me on this form from my credit card.
Date	:
Bank	:	USD account kubaba/bm tourism ltd. 9099869/1 Garanti Bankası - Kızılay branch / Ankara/Turkey
Swift Code	:	tgbatrisxxx/Garanti Bankası - Kızılay branch / Ankara /Turkey