5th CITEM 2005. 5thIBERO AMERICAN CONGRESS
ON MEMBRANE SCIENCE AND TECHNOLOGY
Valencia (Spain), July 6-8 2005
PolytechnicUniversity of Valencia
REGISTRATION AND ACCOMODATION FORM
(Please, fill in using capital letters)
Last Name...... Name...... …...
Institution/Company:......
Mailing Address...... NIF / CIF...... ….
Zip Code...... …….City...... Country...... ……….
Phone...... Fax...... E-mail…….………………………………………
The confirmation message will be sent by E-mail or fax oncethe Technical Secretariat (Ultramar Express- Tui España Turismo S.A) has received the full payment of the registration fee.
1. REGISTRATION
The registration fee covers all the documentation, a copy of the Congress Proceedings, coffee breaks and lunches during the event, a visit to the OceanographicPark and CITEM 2005 Congress dinner. Accompanying persons: registration includes visit to Lladró Porcelain Factory, visit to the OceanographicPark and CITEM 2005 Congress dinner. No refunds will be given after June 3, 2005.
The deadline to register for the Congress is June 30, 2005. After that date registration should be made in the Congress site.
TYPE OF REGISTRATION
/On or before 10 May 2005
/After 10 May 2005
Participants / 250 € / 300 €Students and Scholarships * / 150 € / 180 €
Accompanying persons / 130 € / 143 €
*They must prove their student status.
Accompanying persons:
Name:...... Last Name......
Name:...... Last Name......
(1)...... Euros
2. ACCOMODATION IN CONCERTED HOTELS
The Congress Organisers have negotiated specially discounted rates at several hotels. Accommodation rates per room and night include: accommodation, breakfast and VAT.
- Deadline to guaranteethe hotel room: 3 May 2005. After this date you should check the availability of the hotels with the Technical Secretariat. After 16 of June 2005 no changes and refundswill be accepted.
- Available Dates: arrival on6 July 2005 and departure on9 July 2005. For different dates, please contact the Technical Secretariat(Ultramar Express. Tui España Turismo S.A.) to check the availability.
HOTEL /CATEGORY
/SINGLE ROOM
/DOUBLE ROOM
H. Meliá Rey D. Jaime / 4* / 92,02 € / 92,02 €H. Renasa / 3* / 62,17 € / 83,60 €
H. NH Express Las Artes II / 2* / 65,27 € / 73,83 €
H. Venecia / 2* / 61,10 € / 72,87 €
Residence Hall “Galileo Galilei” / Residence Hall / 42,53 € / 63,06 €
Number of rooms...... double single
I would like to share the double room with......
Arrival Date...... Departure Date...... Number of Nights......
1st Option: Hotel...... 2nd Option:Hotel......
Each reservation should be accompanied by the corresponding payment in order to be effective. You will be sent a notice, via e-mail or fax to confirm your reservation.
ACCOMODATION COST:...... EUROS
INVOICING DATA:
Name / Institution...... …......
Fiscal Address...... ……....
Zip Code...... City...... Contry………......
NIF / CIF ......
METHODS OF PAYMENT:
Payment must be made in Euro and may be made by the following methods:
-Cheque payable to: Tui España Turismo S.A.
-Bank transffer payable to: Tui España Turismo S.A.
BSCH – Av. Juan March Ordinas, 6-1º - 07004 Palma de Mallorca.Spain
Account number: (ES 68 ) 0049- 1853- 17- 2310096665 BIC: BSCHESMM
Please take into consideration that you should also pay the bank administration charges.
Please, indicate the following issue: 5º CITEM 2005- Your surname.
-Credit card: Visa / Mastercard / Eurocard (16 digits)
Card Number
Date of expiry:......
Card holder......
Signature to authorise the payment by means of the credit card.
......
Please, the completed registration and accommodation form should be sent by fax or regular mail, together with the cheque or the receipt of the bank transfer.
Ultramar Express - Event Management- Tui España Turismo S.A.
Gran Vía Marqués del Turia, 49, 6º, L 13 -46005 Valencia. Spain.
Telephone: (+34) 96 352 81 61 – Fax: ( +34) 96 394 11 58
e-mail: -
Date...... Signature......