CCAST ILC Accelerator Workshop

November. 5-6, 2007, IHEP, Beijing

Registration Form

Registration Instructions:

Complete the form first, then click on the submit button.
Upon receipt, a confirmation number(your ID number) will be sent to you automatically by an email.
Please do not resubmit your registration, email us in case of any changes. ccastilc@mail.ihep.ac.cn
For further details, please refer to http://ilc-china.ihep.ac.cn/CIAW07/index.html or contact us .

Title
First Name
Last Name
Nationality
Passport Number
Affiliation
Full Mailing Address
Name of the city	where you want to apply for your visa.
Date of arrival
Date of departure
Telphone
Telefax
E-mail Address

*Accompanied By:

Full Name(s)
Nationality(s)
Passport Number(s)


*Hotel Reservation:

Hotel	Room_number From Nov. To Nov. Number of Nights