Please fill in the form and send by e-mail or fax to the Conference Secretariat. For information or clarifications, please contact Ms. Hazar Nazzal.

Tel:+ 962-6 5525750 Fax: +962-6-5525930 E-mail: ,

Personal information(Please type or print clearly in CAPITAL LETTERS)

Participation at conference as:

Participant StudentInvited speaker

Please choose position:

ResearcherProfessorStudent Other:______

First (Given) name: Middle Initials Last (Family) name:

Name for badge:

Organization:

Postal address:

Postal code: City: Country:

Tel: (country code – area code – tel. no) Fax: (country code – area code – fax no)

E-mail address:

Will you need a certification of attendance Yes No

Special dietary requirements: (please tick your choices)

NoneVegetarianNo Pork Other:______

Accompanying person (Please type or print clearly in CAPITAL LETTERS)

Title: Mr MrsMs

First (Given) name: Last (Family) name:

Name for badge:

Special dietary requirements:(please tick your choices)

NoneVegetarianNo Pork Other: ______

Conference website:

Will you participate to the technical tour on Wednesday 05/11/2014: Yes No

Will you participate to the Gala Dinner on Thursday 06/11/2014: Yes No

Summary of payment

Category / *Registration fee / 1-day attendance / Subtotal
Participant / 400 / 150
Student / 200 / 75
Accompanying person / 150
Total amount = / $

* For more information regarding what is included within each registration category, please visit the conference website.

Method of Payment

BANK DEPOSIT

Bank details:

Bank Name: Arab Bank

Bank Address: 5th circle-Amman-Jordan

Account Number: 032176-1/510

Account Name: International Center for Agriculture research in the Dry Area

Branch Code: 0134

IBAN Number: JO93 ARAB 1340 0000 0013 4032 1765 10

SWIFT/BIC Code: ARABJOAX134

Note: 2259- FUNDS IN TRUST OliveBioteq Conference

Note: All bank transfers should be exclusive of all bank charges. Please make sure to indicate participant's name on the bank transfer form. For submission, attach the bank transfer form to the registration form of the conference.

On desk Registration:

On desk registration is reserved for participants from Iran, Sudan and Syria

An e-mail message confirming receipt of payment will be sent to the address provided above. Please have the confirmation message with you at the registration desk, in order to facilitate the registration process.

Important note: Any cancelation or change must be received and confirmed by the Conference Secretariat in official written notice via letter, fax or e-mail before 20 September2014for 85% refund or before 20 October 2014 for 70% refund of total payment. No refund will be granted after this date or for no-show. The refund will be processed one month after the conference, less the applicable taxes and bank handling charges.

Conference website: