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 July 30, 2004	After July 30, 2004
Full Rate	450 USD	500 USD
Author	300 USD	350 USD
Student (with photocopy of student identity card)	150 USD	200 USD
Accompanying person	150 USD	200 USD
Daily Registration	300 USD	350 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. 9095531 Garanti Bankası - Tunalı Hilmi branch / Ankara/Turkey