Advances in Nanophotonics

First annual workshop on

Advances in Nanophotonics

October 10 and 11, 2005, Heraklion, Crete, Greece

And PHOREMOST meeting,

October 12 and 13, 2005

Registration & Accommodation Form

This form should be submitted either by email or by Fax to: MITOS S.A., Science and Technology Park of Crete, P.O. Box 1447, Voutes, Heraklion, 71110, Crete, Greece,

Fax: +30 2810 391915, e-mail:

Deadline for submission 15 September, 2005

PARTICIPANT INFORMATION

Title: / Ms. / Mr. / Dr. / Prof.
First Name:
Last Name:
Company/Institution:
Address:
City: / Postal Code:
Country: / Tel.:
Fax.: / e-mail:
Arrival date: / Departure date:

REGISTRATION FEE (150 €) PAYMENT

A registration fee of 150 € is required together with your registration. It includes welcome reception, abstract book, coffee breaks and workshop dinner.

Payment method (to proceed see information on next page):

Credit card

Bank transfer

Other (specify) ……………………….

HOTEL RESERVATION (tick the hotel & room of your choice)

HOTEL / SINGLE ROOM / TWIN ROOM
Candia Maris Hotel(fully inclusive) / 95 € / 130 €
Agapi Beach Hotel (fully inclusive) / 70 € / 112 €
Santa Marina Hotel (half board) / 50 € / 78 €
Marilena Hotel (half board) / 46 € / 56 €

o  The above rates are per night, per room and reservations will be made on a first come, first serve basis. Candia Maris is the meeting hotel. The closest one is Agapi Beach.

o  For participants wishing to pay for their hotel accommodation in advance, they may do so by completing the information below

I will pay for my hotel accommodation at the secretariat desk during the meeting.

I will pay for my hotel accommodation in advance, by

Credit card

Bank transfer

Other (specify) ……………………….

PAYMENT BY BANK TRANSFER

Bank: Piraeus Bank Branch: Science & Technology Park of Crete
Account No. 5751-015 322-326
BIC: PIRBGRAA
IBAN: GR 880172 7510 0057 5101 5322 326

Payment made by Bank Transfer on _ _ / _ _ / _ _ (Please fax a copy of bank receipt to: + 30 2810 391915)

PAYMENT BY CREDIT CARD

Credit card: / American Express 5 / Master Card 5 / Visa 5
Name on card:
Card number:
Expiration date:
Last 3 digits on reverse side of credit card:
Passport number

Total amount to be charged to card ______Signature______