2nd Beijing International Congress on Medical Radiation Physics

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Registration Form

Name:.................................. ..................................................................degree:...........................Mr. Ms.
           (family name)                                          (given name)

Institution:.................................................................................................................................................

Address:...................................................................................................................................................

.........................................................................................................Postal code:....................................

Phone:............................................................................ Fax:.................................................................

E-mail:...................................................................................................Please print clearly

Registration fees:

Participant:           early (until March 15, 2000)             US$ 380*

                                late (March 15 to May 1, 2000)       US$ 450

                                on site US$ 500 ___________

Companion: Name:......................................................... US$ 120 ___________

* For early registrants from U.N. designated developing countries: (until March 15, 2000): US$ 280

Pre-Congress Tours:

Tour line 1: Guangzhou - Guilin - Xian - Beijing (5 days/4 nights)
US$ 701  x ___ = _________

Tour line 2: Guangzhou - Guilin - Chongqing - Yichang (Three gorges tour) - Beijing (5 days/4 nights)
US$ 780 x ___ = _________

Tour line 3: Guangzhou - Hangzhou - Yellow Mountain - Beijing (4 days/3 nights)
US$ 598 x ___ = _________


Date:............................................................... Total amount enclosed USD ______________

Refund Policy: Before April 1, 2000, 85% refund. Before May 1, 2000, 50% refund.
After May 1, 2000, no refund will be made.

Please print this page using your local printer, and
make check payable to Beijing International Congress and mail to:

American/European Registrants:

Raymond K. Wu, Ph.D.
Eastern Virginia Medical School
600 Gresham Drive,
Norfolk, VA 23507
Tel: (757) 395-8610
Email: RayKWu@aol.com


European Registrants:

Jan van Dam, Ph.D.
Professor, Katholieke Universiteit Leuven
de Croylaan 58
B-3001 Leuven, Belgium
Tel 32/16/32.21.34; Fax 32/16/32.29.95
Email: Jan.VanDam@lad.kuleuven.ac.be


Other Registrants:

Prof. Yimin Hu
Cancer Institute (Hospital), CAMS
Beijing 100021, China
Tel & Fax: 86-10-6773-7011
Email: huyiminr@public.bta.net.cn

Last update: Dec 02, 1999

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