Registration Form
Please complete all 3 pages and return by e-mail, fax or post to:
Mrs. Pham Thi Hong Hanh, National Institute of Plant Protection Dong Ngac- Tuliem- Hanoi - Vietnam Fax: 84-4 8363 563; E-mail: nipp-khkh@hn.vnn.vn bio-nipp@hn.vnn.vn
Registration is available up to and during the Conference, however, early registration is strongly recommended. All costs are in Vietnamese Dong or US Dollars and are inclusive of GST.
Mr/Mrs/Ms/Dr: Family Name:
Given Names:
Organisation/Institution:
Address:
Postcode/Zipcode: State: Country:
Telephone (work): Telephone (home):
Fax: Email:
The above details will appear on the delegate list provided to delegates and sponsors.
I do/ do not wish for my details to be provided to delegates, sponsors or any other party
I do/ do not wish for my details to be used for any other purpose other than the dissemination of information for this (or subsequent relevant) conference
Preferred Name on Badge
Paid Accompanying Person's Name
Paid Accompanying Person's Preferred Name on Badge
I am a student ( YES / NO) and wish my paper/poster to be considered for the student prizes for best paper/poster YES / NO
I am from a developing country ( YES / NO) and wish my paper/poster to be considered for the prizes for best paper/poster YES / NO
Accommodation -see separate flyer or website for details of other hotels and advantageous prices.
All requests for accommodation must be accompanied by payment of one night's deposit. Reservations cannot be guaranteed if payment is not received by 20 July 2006
Registration Fees
Social Events
Welcome Reception/Dinner-Limited beverages included x @ $20 $
Conference Dinner Included for Full and Concession Registrants only
Yes I will attend No I will not attend
Additional tickets * x @ $40 $
*including Accomp. Persons
Wednesday Tour Included for Full, Concession Registrants and Accompanying Persons
Yes I/we will attend x No I/we will not attend
Additional guests x @ $40 $
TOTAL PAYMENT $
Vietnamese and US dollar cheques (drawn on an Vietnamese bank) or money orders in Vietnam and US dollars should be made payable to the 3rd ICRBM or Please debit my:
Bankcard MastercardVisa . American Express . Diners .
Card no.
Amount $ Expiry date /
Cardholder's Name
Cardholder's Signature
Students must provide the following information
Institution
Major Supervisor
Supervisor's e-mail address
Cancellation Policy
A refund of registration fees (less an administrative fee of $ 65) will only be available by providing written notification of your cancellation to the Conference Secretariat prior to 22 June 2006. Refunds after 22 June 2006 will be at the sole discretion of the conference committee.
By submitting this registration, you acknowledge and accept the cancellation and refund policy (outlined above).
Registration confirmation
Following receipt of your registration, a confirmation letter and tax invoice will be forwarded to you.
CONFERRENCE WEBSITE: http://ICRBM2006.ioz.ac.cn