ROW4
HOTEL REGISTRATION FORM
MAGNETIC ISLAND TROPICAL RESORT, TOWNSVILLE, AUSTRALIA 21-23 April 2004 REGISTRATION AND ACCOMMODATION FORM |
NAME |
|
ADDRESS |
|
PHONE |
|
FAX |
|
EMAIL |
| ACCOMMODATION DETAILS | |
| I
require the dinner/bed/breakfast accommodation package: |
4
nights Tuesday 21 – Saturday 24
|
| 3 nights Tuesday 21 - Friday 23 | |
|
I
require single
occupancy for: |
4
nights ($666) or
|
| 3 nights ($500) | |
Twin
share
|
4 nights ($466) or |
| 3 nights ($400) | |
| Triple share | 4 nights ($406) or |
| 3 nights ($305) | |
Quad
share |
4 nights ($366) or |
| 3 nights ($275) | |
If you are sharing please list the names of other occupants here:
|
|
| Please remit a deposit of $AUD100 (or the full amount) to secure your reservation. | ||
Credit
Card Type: |
VISA | MASTERCARD |
| DINERS | AMEX | |
Name on Card: |
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Card Number: |
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Expiry Date: |
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Amount $AUD |
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SIGNATURE: |
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| WORKSHOP DETAILS | |
I will
present a paper in the session: |
Algorithms and Development Applications |
| Monitoring and surveillance | |
Title of Paper: |
|
I would
like to have my paper peer reviewed: |
YES NO |
Please
FAX this page to Emma at BEFORE JANUARY 31,2004 |
|