Rencontres du Vietnam

Beyond the Standard Model in Particle Physics

Quy Nhon, Vietnam, July 15 - July 21, 2012

Conference Registration And Hotel Reservation Form

deadline June 15th, 2012

if you cancel a hotel reservation, please do so as soon as possible, and in any case before June 15th,, 2012, otherwise the hotels will retain the deposit that the conference will have paid in your place.

Please make sure that your name, the address of your institute and your email are given correctly on this form; this information will appear in the proceedings, and we must have a reliable way of conctacting you. Please enter both emails as requested on the form (current and one up to date of conference, even if identical; you will get an error message if one of them is left blank!).

Please do not register more than once. When you register electronically (see below), you should wait until the system responds with a confirmation that your form has been successfully sent. Depending on the internet traffic, this may take a few tens of seconds; after confirmation you may shut down your browser. Only if you are told that the form could not be sent should you resubmit (probably somewhat later!).

Registration

You

Mr Ms

Professional status

Family name First name

Date of birth

Professional interests  


I plan to submit one or more contributions for a poster session
with the following titles:  

I plan to submit oral contributions to a parallel session
with the following titles:  

Your Institute

Address line 1  
Address line 2  
Address line 3  
Address line 4  
Address line 5  

Country  

Your email obligatory; please enter it again in blue box below even if same !! Your phone Your fax

Your mailing address up to the conference, if different from above

Address line 1  
Address line 2  
Address line 3  
Address line 4  
Address line 5  

Country  

Your email up to the conference: obligatory even if same as above Your phone Your fax

Vegan meals required

yes no

or

Vegetarian meals required

(fish accepted)

yes no


Hotel Reservation

Reservations are made for the whole duration of the meeting, i.e. From Sunday noon, July 15th, to Saturday morning (lunch included), July 21st.

Note that all rooms are non-smoking

I would like a single room

I wish share a double room with my spouse

I accept to share a twin room with another participant


To help us optimize your transfer from Qui Nhon airport to the Seagull Hotel, please give the following information:
I/we will arrive at Qui Nhon airport      
I/we will leave      


I/we have applied for a visa by internet - click yes or no

Only if yes please give us the following information (which will help us expedite immigration formalities), otherwise leave blank:

       

I/we would be interested in a post conference tour (click on link in lefthand column for info) - click yes or no




If for some reason on line registration does not work in your case, you may print and fill in this form manually, and send it to:

Ms Hady SCHENTEN

Rencontres de Blois
BP 33, F-91192 Gif sur Yvette
France
Tel : 33 (0)1 69 28 51 35
Fax : 33 (0)1 69288659
email: hady.schenten@orange.fr

Send this form electronically by pressing this button:

Please wait for electronic confirmation before leaving your browser. This may take a few tens of seconds if internet traffic is heavy. Do not resubmit unless you are informed that the form could not be sent. You should also receive a copy of the form by email a little later. Thank you.