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