LHC-Praha-2003

Physics at LHC

July 6-12, 2003

Prague, Czech Republic

REGISTRATION FORM

Deadline: June 6, 2003

Please fill in this form to register to LHC-Praha-2003. We also accept e-mail with the same information, but electronic submission of this web form is strongly preferred.

Registration

Prof. Dr. Mr. Ms. or

Family name:

Name(s):

Institution (full name):

Home Institute address:

Phone (office):

FAX:

E-mail:

I am planing to give a talk:
Preliminary title:

Preliminary arrival date:

Preliminary departure date:

I am planing to reach Prague by plane, flight N

by train, N

by car

Visa Information

If you need the visa for Czech Republic, please, specify

Date, month and year of birth:

Sex:

Citizenship:

Passport number:

Date, month and year of issue:

Date, month and year of expiration:

Place of applying for the visa:

(country and city in which the Czech Consulate is available)

Accompanying Person(s)

Name(s):

(children under 16, if any, name and year of birth)

Housing Reservation

I take care of the accommodation by myself

I will use the service of Organizing Committee and book

- Hotel Corinthia Panorama, (****) standard

Single room, 60 EUR/night
Double room, 70 EUR/night

- Hotel in Prague Historical Centre, (****) standard

Single room, 90 EUR/night
Double room, 100 EUR/night

- Hotel in Prague Historical Centre, (***) standard

Double room, 40 - 50 EUR/night

- Charles University Guest House

Double bed studio, 30 EUR/night
car parking

- Charles University Hostel

Double bed room, 18 EUR/night

I will share room with:

I would like to draw attention of the Local Organizing Committee to the following requirements and/or comments:

Comments:

Last modified: May 27, 2003 by Elena Kolganova