Press Release┊Programme┊Registration Form┆Booking Form┆Participants┆中文版             July  22, 2002
 

REGISTRATION FORM

  One copy of this form should be completed for each participant (Accompanying person should be included the same form). Please type or print clearly and provide the information as you wish it to appear on your badge and in the list of participants. 

Personal Details  

Participant:

Mr.

Ms.

Mrs.

Dr.

Prof.

Surname:   

Given Name:

Company/ Institution:

Position:  

Address:  

Town/City:

Post/Zip Code:

Country:

Telephone (Country Dialing Code):

Number:

Fax (Country Dialing Code):

Number:

E-mail:  

Registration Fee:USD$300

Payment

Credit Card Options:

Visa

Euro/Master card

Card Number:

Expiry Date:

Name on Card:

Signature:  

Date:        

Accompanying Person:  

Surname:

Given Name:

      Male

    Female

Surname:

Given Name:

      Male

    Female

Surname:

Given Name:

      Male

    Female

Registration Fees:USD$180 (each)  

Total:  

Payment

Credit Card Options:

Visa

Euro/Master card

Card Number:

Expiry Date:

Name on Card:

Signature:   

Date:        

  
　

　

Please return the completed form to:

International Cooperation Division

Shanghai Library

1555 Huai Hai Zhong Lu

Shanghai 200031, China

Tel:  +8621 6445 5004

Fax:  +8621 6445 5006

Email: jmwu@libnet.sh.cn