Registration

Registration Form

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Read the descriptions of the Wednesday excursion and the Companions' programme before filling in this form.

Identification

    Surname: First Name:
      Title:  Nationality:
  Institute:
    Address:
               
Postal code:  City:
    Country:
      Email:
      Phone:  Fax:

Requirements

Special dietary requirement. Please specify :

Require special services as disabled attendee. 
   Please specify :  


I wish to participate in the Friday visit to CERN :
   No     Yes, with  companions (please indicate number).

Conference Fee

The conference fee includes participation in all the conference sessions, transport to and from the official conference hotels, lunch at the Penta on Monday, Tuesday and Thursday, the excursion, a box lunch and dinner on Wednesday, and transport to CERN for the guided visit on Friday.

The conference fee does not cover the Gala dinner on Thursday evening, the lunch at CERN on Friday, nor the participation by companions in the Wednesday visit. These optional items should be paid for at the same time as the conference fee. 

 
Registration before 14 June 1996        : 500 CHF 
Late registration (until 19th July)     : 550 CHF

Gala Dinner Tickets                     :  80 CHF each (for delegates and companions)
Lunch at CERN on Friday                 :  20 CHF each (for delegates and companions)
Extra Ticket(s) for Wednesday Excursion :  80 CHF each (for companions only).

Wednesday Excursion

 The programme consists of an outing in the Gruyère Region. Choose your preference from the pop-up menu below, read the descriptions first.

NB Good walking shoes, wind-proof jacket and sun protection required if you choose red or white options.

Companions' Programme

I will be accompanied to Linac96 by person(s).

It is likely that my companions will wish to participate in the companions' programme :
Yes No
If YES, please fill out the next part of the form. Tickets may be purchased at the registration desk in the Penta. Please do not pre-pay for these trips, as they will depend on the level of interest shown. 

Names of Companions:
Indicate one or more of the activities your companions are interested in, read the descriptions first. 
Tour of Geneva & visit of Red Cross Museum
"Salt, bread and wine"
Boat trip to Yvoire and visit*
Chamonix and Mont Blanc*
* Please get a French visa in your home country if you wish to visit Yvoire and/or Chamonix and if your particular nationality requires you to have a visa for France.

Hotel Booking

Accommodation must be booked by you yourself; our Secretariat cannot do it.

The hotel reservation form should be returned to the Penta Hotel.

Hotel Penta - Linac96 Conference
75 avenue Louis Casaï, 1216 Cointrin, Geneva, Switzerland
Tel. +41 22 798 47 00, Fax +41 22 798 77 58
Room rates, including breakfast, are:
Single : CHF 138, Double CHF 170

Total Payment

The amount of my payment to LINAC96 is as follows : 
Conference Fee (before 14 June 500 CHF, until 19 July 550 CHF)  

 ticket(s) for the Gala dinner at CHF 80 each               
 ticket(s) for lunch at CERN on Friday at CHF 20 each       
 extra ticket(s) for the Wednesday excursion at CHF 80 each 
                                                             ___________

 TOTAL

Method of Payment

Bank Transfer (please note that such transfers are liable to take a long time, so beware the deadline.) 
     Bank transfer through my own bank,
         which I have requested on  (dd/mm/yy)

     Bank transfer through my laboratory,
         which I have requested on  (dd/mm/yy)
Cheque 
     Banker's Cheque, which I send separately

     Personal Cheque, which I send separately 

made payable to "LINAC96 Conference" account number C7-117.927.0
at the  Swiss Bank Corporation, CERN-Meyrin, 1211 Geneva 23, Switzerland
Credit Card (only Eurocard/Mastercard can be accepted): 
     Card number: Expiry date:(mm/yy)
Name of card holder:

By returning this form I authorise to charge my account
for fees indicated above.
Information concerning credit card may be sent by separate mail, if you prefer.

Additional Information

linac96@www.cern.ch