REGISTRATION FORM: (one participant per form and please copy this form as needed)  Please copy this form and e-mail, fax, or mail the information to ASA AND copy to Spiez Laboratory..

ASA fax: 1-410-638-9481
Irma Lehnherr fax: 41-33-228-1402

ASA e-mail:
Irma Lehnherr e-mail:


Spiez Laboratory Switzerland

25-30 April 2004
Spiez Switzerland

Use BLOCK letters

1 FAMILY NAME:______________________________ FIRST NAME(s):____________________________
2 Title/Profession/Organization: ______________________________ ____________________________________________________
3 Mailing Address:___________________________________________________


City __________________________________________________

Country ___________________________________________________

4 Phone: __________________________________________ Fax: _____________________________________
  E-mail: _________________________________________  
Accommodation Request:
5 Request hotel. Note if reservation is for single (S), double (D), or double with single occupancy (D/SO)
All prices are in Swiss Francs, CHF!!

Hotel _____________________ S_________ D/SO____________ D __________

  Hotel Royal St. Georges (4 star):
Single room CHF 130
Double room, single occupancy CHF150
Double room, double occupancy CHF 200
  Hotel Chalet Oberland (3 star):
Double room, single occupancy CHF 110
Double room, double occupancy CHF 170
  Hotel Harder-Minerva (2 star): or Single room CHF 90
6 Arrival Time: Date& Time to Zurich or Geneva by Airline and flight number or other means
  Departure Time: Date& Time from Zurich or Geneva by Airline and flight number or other means
7 Abstract Submission (by 15 December 2004):  
  Abstract Title: ________________________________________________________________________
  Abstract Authors: _________________________________________________________________________
8 Individual Registration Fees:
for Individual Members before 25 February 2004 from 25 February 2004
Government /Academia CHF 890 CHF 1080
Industry CHF 1180 CHF 1390
Acommpanying Person  
FAMILY NAME:______________________________ FIRST NAME(s):____________________________

Accompanying Persons Fees:

Lunch CHF 16
Dinner CHF 28
Welcome Party CHF 30
Symposium Dinner CHF 90
Excursion and farewell party with dinner CHF 50
10 Terms of Payment:  
  A. Payments are accepted by credit cards Visa, Master Card, EuroCard, Diners Club and American Express. Payment is also accepted via bank transfer or bank check, or by cash at registration if prior approval has been obtained. Refund policy is on the ASA CBMTS website:










Master Card






  Card Number ____________________________________

Expiration Date ______________________________

Card Member Name ____________________________________

Billing address if different than item #3 ____________________________________


  B. Bank data for CBMTS V Switzerland:

Account No. 42 3.694.965.22
Swift code: KBBECH2237A
Bankclearing No. 79030


Berner Kantonalbank,
Filiale Spiez,
CH-3700 Spiez,


Back to CBMTS V information page.

Back to CBMTS home page

Back to ASA home page

Last update: 3 Nov 2003, BBSP