CHT'01 PRE-REGISTRATION FORM

Title:          
Given name:       Family name: 
Affiliation:    
Department:     
Postal address: 
                
                
Post/zip code:  Country: 
Telephone (including country and area codes):
                  Fax: 
Email:          

	     I plan to attend CHT'01
	     I may attend CHT'01
             I will probably not attend CHT'01, but please keep me informed

I will be accompanied by 

Tentative title or topic area: 

		


I am interested in a pre-conference tour   Yes
                                           Maybe
                                           No   
lasting 
         three days
         seven days
         two weeks
         
         


I am interested in a post-conference tour  Yes
                                           Maybe
                                           No   
lasting 
         three days
         seven days
         two weeks