SNSC-01 Registration Form Name: Affiliation: Full address: Country: e-mail: Telephone: Telefax: For lunches etc.: o vegetarian o regular food Conference Registration fee: Fees are given in Euro. Exchange rate on June 13: 1 USD = 1,20 Euro. o conference fee *) EURO 185.- (USD 154.-) o number of banquet tickets, price per ticket EURO 44.- (USD 37.-) Total costs: ..... EURO *) includes abstracts, refreshment breaks, lunches, shuttle from conference hotel to the conference site and back Payment: Payment should be made in EURO. Please note that bank fees must be paid by the participant. o payment will be made by bank transfer into the following account: Raiffeisenbank Hagenberg/Pregarten BLZ (bank code): 34151 Account number: 780.000.25.320 Specify: SNCS Workshop 2001 and name of participant o I hereby authorize the conference treasurer to charge my credit card for the amount mentioned in Total costs. o American Express o Eurocard/Mastercard o Visa Card holders name: Credit card number: Expiration date: For hotel reservation in conference hotels: Arcotel in the city of Linz o single room EURO 75.00 (USD 62.50) o double room EURO 98.00 (USD 81.75) Student residence in Hagenberg at the conference site (25 km outside of Linz) o single room EURO 21.00 (USD 17.50) o double room per person EURO 21.00 (USD 17.50) Expected date of arrival: Expected date of departure: Payment should be made directly to the hotel, when checking out. A deposit is not required. Please communicate any changes in arrival or departure dates promptly. In case of non-apperance, you can be charged for the costs involved. For those participants, who stay longer, there is the possibility for a one day trip to Salzburg. If you are interested in this, please mark the following: o I want to participate in the trip to Salzburg. Special requests: Date: Signature: The completed form can be either mailed, faxed or emailed to: Mrs. Ramona Poechinger RISC-Linz Johannes Kepler Universitaet Linz Schloss Hagenberg A-4232 Hagenberg, Austria Fax: +43 732 2468 9930 Email: ramona.poechinger@risc.uni-linz.ac.at For further information see the web page http://www.risc.uni-linz.ac.at/conferences/snsc01/.