A. DELEGATE DETAILS
Title
Prof
Dr
Mr
Mrs
Ms
Name
*
Surname
*
Paper Title (If any)
Affiliated Organization
*
Postal Address
*
Postcode / Zip
Country
Select Country
Albania
Algeria
American Samoa
Andorra
Angola
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia And Herzegowina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Cote D'Ivoire
Croatia (Local Name: Hrvatska)
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See (Vatican City State)
Honduras
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Hungary
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India
Indonesia
Iran (Islamic Republic Of)
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
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Korea, Dem People'S Republic
Korea, Republic Of
Kuwait
Kyrgyzstan
Lao People'S Dem Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia, Federated States
Moldova, Republic Of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nepal
Netherlands
Netherlands Ant Illes
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint K Itts And Nevis
Saint Lucia
Saint Vincent, The Grenadines
Samoa
San Marino
Sao Tome And Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia (Slovak Republic)
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia , S Sandwich Is.
Spain
Sri Lanka
St. Helena
St. Pierre And Miquelon
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic Of
Thailand
Togo
Tokelau
Tonga
Trinidad And Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
UK
United States
Uruguay
Uzbekistan
Venezuela
Viet Nam
Virgin Islands (British)
Virgin Islands (U.S.)
Western Sahara
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
*
Phone
*
Mobile
Fax
Email
*
Title and Name of the Accompanying Person (If any)
B. CONFERENCE REGISTRATION FEES
All prices quoted are in Euros () and include VAT. Coffee Breaks and Conference Proceedings Book are free with registration.
Conference Registration
Early (By Sep 30, 2008)
Late (After Sep 30, 2008)
Fulltime Registration (Academia)
300
350
Fulltime Registration (Student)*
100
100
B SUBTOTAL
*Student rates are available to students who present appropriate creditentals (Student ID Card Copy, etc.) when they register at the conference.
C. DINING
Gala Dinner and Lunches (x3) (Full Package)
100
Gala Dinner Only
45
One Lunch Only
20
Gala Dinner and Lunch (x1)
65
Gala Dinner and Lunch (x2)
85
C SUBTOTAL
D. SOCIAL ACTIVITIES
Sightseeing Tour (One day trip on November 14, to Ephesus, the House of Mother Mary, Kusadasi and Sirince)
35
D SUBTOTAL
E. DIETARY REQUIREMENTS
Please advise any dietary or other special requirements:
Delegate:
Accompanying Person (If any)
F. PAYMENT
Either credit card details or bank transfer remittance form should be made available. If you choose to pay with bank transfer please fax the remittance form with your registration.
SECTION B
Registration Fees:
*
SECTION C Dining:
*
SECTION D Social Activities:
*
GRAND TOTAL
*
PAYMENT METHOD * (For either method you choose, fill all the information requested in. )
By Bank Transfer:
A Payment of
has been transferred to the account of Izmir University of Economics.
Bank: Is Bankasi A.S. Ege Kurumsal Sube (3399) Euro Account Nr: 6313
IBAN: TR880006400000233990006313 Swift Code: ISBKTRIS
Please write "ICOVACS 2008 " and the participant's name on the remittance.
By Credit Card:
Please debit my credit card for my registration fees and supply my credit card details to the hotel to guarantee my reservation.
IMPORTANT NOTE: For safety reasons, it is required that the applicant's name should appear on the credit card. If you do not personally own a valid credit card, please send the payment via bank transfer. Payments made through credit cards with other holder names will not be processed.
Mastercard
VISA
16 Digit Card Number:
Expiry Date (Mm/Yy) :
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02
03
04
05
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2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
>
CCV Number (Credit Card Verification Number):
This is the last three digits of the number at the back of your credit card.
Full name on Credit Card:
G. REGISTRATION CANCELLATIONS AND REFUNDS
If cancellation of your registration is necessary, please e-mail or fax written notice to the Conference Managers. Cancellation fees apply to all categories of registration. If registrants cancel:
Before September 30, 2008: The penalty is 25% of the registration fee. The remaining amount will be refunded.
On or after September 30, 2008: There will be no refunds for cancellations received.
Any other information you like to provide:
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