WWW94 -- Registration Form

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form): 






                        WWW 94

                   Registration Form


Identification
==============
           Name: ..............................
    Affiliation: ..............................
        Address: ..............................
Street & number: ..............................
        Country: ..............................
    Postal Code: ..............................
           City: ..............................
Postal District: ..............................

         E-mail: ..............................
          Phone: ..............................
            Fax: ..............................

Name & Affiliation on badge if different from above:
 ..................................................

Preferred size of your free WWW T-shirt:  [_] S  [_] M  [_] L  [_] XL

[_] Special dietary requirement
[_] Require special services as disabled attendee
[_] Do not want name to appear on attendee list


Hotel Booking
=============
Please book at the hotel
   Moevenpick, 100 CHF per room per night
      single room [_]
      double room [_]
   Le Warwick, 155 CHF per room per night
      single room [_]
      double room [_]
for  ....  nights
I will arrive on ........ and depart on .........


Conference fee
==============
The complete conference registration fee includes
transportation to and from the two listed hotels,
lunch on Wednesday, Thursday and Friday, the
conference dinner on the Lake boat on Thursday
evening and the tutorials.

Normal fee
----------
Registration before April 30: [_] 500 CHF
Late registration:            [_] 600CHF

Attendees from Academic Institutes
----------------------------------
Registration before April 30: [_] 400 CHF
Late registration:            [_] 500 CHF

Students
--------
Registration before April 30: [_] 300 CHF
Late registration:            [_] 400 CHF

Business Path only
------------------
(Thursday afternoon and dinner)
Registration before April 30: [_] 300 CHF
Late registration:            [_] 400 CHF

Extra dinner tickets: .... at 80 CHF each

Method of payment
=================
 [_] Cheque:
     made payable to "WWW94 Conference",
     account number C7-116794.0 at the
     Swiss Bank Corporation, CERN-Meyrin,
     CH-1211 Geneva 23, Switzerland.

Credit Card:
 [_] VISA
 [_] MasterCard
 [_] Amexco
 [_] Diners
Card number: .......................
Card expiry date: ...........

I authorise to charge my account for the fees
indicated above.

Signature: .....................


Send to:
              WWW94
         c/o Anne Perrelle
                CERN
        CH - 1211 Geneva 23
             (Switzerland)

Telephone: +41 22 767 5005   Fax: +41 22 767 8730
e-mail: www94@www1.cern.ch


RC 19 Feb 94