(Upon completion send by e-mail to ASA: CBMTS@asanltr.com and Croatian Organizing Committee: slavkobokan@hotmail.com and zvonko.orehovec@zg.t-com.hr or fax : ASA at 1-808-432-9670 or mail: ASA, PO Box 6409, Kaneohe, Hawaii 96744 USA)

 

Registration Form for:

The 16th meeting in the CBMTS series:

CBMTS-Industry VI

"Fifth World Congress on Chemical, Biological and Radiological Terrorism"

Dubrovnik, Croatia
5 through 10 April 2009
with a very important Pre-Congress Workshop on 4/5 April

 


Personal Information:

Family Name:

First Name(s):

Title / Profession:

Organization / Company:

Postal Mailing Address:

Phone:

Fax:

E-mail address:

Accompanying Person:

Relationship:

NOTES:


Abstract Title:

Abstract has been sent: (give date)

or will be sent: (give date)

Accommodation Request:
          CBMTS Industry VI participants will be accommodated at the CBMTS venue: Hotel Croatia in Cavtat, a suburb of Dubrovnik. When Hotel Croatia is fully booked, CBMTS will assist in assigning other near-by Hotels in Cavtat.

Hotel Fees:           

Room Type
Room Rate
Double Room (DR) with Single Occupancy (SO) and breakfast
EURO 105.00 daily
Double Room (DR) with Double Occupancy (DO) and breakfast
EURO 120.00 daily

 

Room Preference:

Single

Double

Dates:

 

Travel Info:

Flight Arrival to CBMTS (date/ time):

Airline/Flight Number:

Flight Departure (date/ time):

Airline/Flight Number:

Registration Fees and Payment:

Registration Fee:

Before 15 January 2009

After 14 January 2009

 

Euro 750

Euro 800

Registration:

Hotel Deposit: Euro 85.
Note: When registration is provided - hotel deposit is not required.

Total Registration and Hotel Deposit:

*Credit Card Type:

Credit Card Number:

Expiration Date(MM/YY):

 

 

 

Name on Card:

Signature:

(Upon completion send by e-mail to ASA: CBMTS@asanltr.com and Croatian Organizing Committee: slavkobokan@hotmail.com and zvonko.orehovec@zg.t-com.hr or fax : ASA at 1-808-432-9670 or mail: ASA, PO Box 6409, Kaneohe, Hawaii 96744 USA)

The Registration Form is also availible in .doc and .pdf files

Back to CBMTS page
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Updated by Evan Saunders, 31 July 2008

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