Registration

Registration Form

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See the descriptions of the Wednesday excursion and the Companions' programme.

Identification

Surname     : .........................  First Name : .............................

Institute   : ................................................. Title : ...........

Address     : ................................................. Number: ...........

City        : ................................................. Code  : ...........

Country     : .........................  

Nationality : ........................   E-mail     : .............................

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

Requirements

[__] Special dietary requirement                    : .............................

[__] Require special services as disabled attendee  : ............................. 

I wish to participate in the Friday visit to CERN   : YES [__]        NO [__]

                                 with [__] companion(s) (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 of companions in the Wednesday visit. These optional items should be paid for at the same time as the conference fee.

Registration before 14th June         :  CHF 500
Late registration (until 19th July)   :  CHF 550 
Gala Dinner tickets                   :  CHF  80 (for delegates and companions).
Lunch at CERN on Friday               :  CHF  20 (for delegates and companions).
Extra tickets for Wednesday excursion :  CHF  80 (for companions only).

Wednesday Excursion

The programme consists of an outing in the Gruyère Region. Please indicate your choice for one of the following activities :

[__] (Yellow) Easy-going: Walk from the village of Moléson
[__] (Blue) Leisure Programme : Visit of the old town of Gruyères
[__] (Brown) Visit of the Nestlé chocolate factory in Broc
[__] (Green) Sports Programme in Moléson-Village
[__] (Red) Programme for good mountain walkers
[__] (White) Other option for mountain walkers

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  ..... persons.  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 and visit of the Red Cross Museum

[__] "Salt, bread and wine"

[__] Boat trip from Geneva to Yvoire (France*) and visit of Yvoire

[__] Chamonix and Mont Blanc (France*)

* 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 Accommodation

The accommodation you choose must be booked by you yourself; the 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)    CHF .....

 ...... ticket(s) for the Gala dinner at CHF 80 each                CHF .....
        (for delegates and companions)
 ...... ticket(s) for lunch at CERN on Friday at CHF 20 each        CHF .....
        (for delegates and companions) 
 ...... extra ticket(s) for the Wednesday excursion at CHF 80 each  CHF .....
        (for companions only)
                                                                    ----------
                                                       TOTAL        CHF .....
                                                                    ----------

Method of Payment

 [__]  Bank transfer through my own bank, which I have requested on ........... *
 [__]  Bank transfer through my laboratory, which I have requested on ......... *
 [__]  Personal Cheque, which I enclose herewith
 [__]  Bankers's Cheque, which I enclose herewith
      
       made payable to "LINAC96 Conference", account number C7-117.927.0 at the
       Swiss Bank Corporation, CERN-Meyrin, CH-1211 Geneva 23, Switzerland 
       
       (* Please note that such transfers are liable to take a long time, so 
       beware the deadline.)

 [__]  Credit Card (only Mastercard/Eurocard can be accepted) :
                
                  Card number         : .......................
                  Card expiry date    : .......................
                  Name of card holder : .......................
           
       I authorise to charge my account for the fees indicated above.

       Signature (for credit card) : ..........................  Date : ..........
-----------------------------------------------------------------------------------

Signature : ....................................    Date : .......................
-----------------------------------------------------------------------------------

Please send to : LINAC96, c/o Susan Neboux,
CERN-PS Division, CH - 1211 Geneva 23 (Switzerland)
Telephone : +41 22 767 2523 Fax : +41 22 767 9145
E-mail : linac96@www.cern.ch

sln 3 February 1996