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POPULATION APPROACH GROUP EUROPE
VERONA – ITALY   12-13 JUNE 2003

REGISTRATION FORM 

Family Name_____________________ First Name	
Affiliation (Institution/Company)	
Address	
ZIP Code and City	Country	
Telephone	Fax 	E-mail	                                    
Accompanying Person
Family Name	First Name	

REGISTRATION FEES

INDUSTRY	€  180,00
UNIVERSITY	€  120,00
PHD STUDENT 	€    20,00
      
HOTEL RESERVATION REQUIRED?              YES                                 NO   

HOTEL 4 STARS 	SINGLE ROOM    €  95,00		DOUBLE ROOM   €  115,00
HOTELS 3 STARS	SINGLE ROOM    €  77,00		DOUBLE ROOM   €    90,00
Rates per room, per night, continental breakfast included

HOTEL CATEGORY              4 STARS                                  3 STARS           
                        
ROOM TYPE                SINGLE ROOM                        DOUBLE ROOM  

ARRIVAL DATE	DEPARTURE DATE	TOTAL NIGHTS	

PRE-PAYMENT 

-REGISTRATION FEE                                                                                                             €	
Full pre-payment required

- HOTEL RESERVATION (1 night)                                                                                         €	                                                                                       
First night deposit required 

- RESERVATION FEE		 €                             10,00

TOTAL                                                                                                             €	

 IF THIS BOX IS CHECKED PLEASE SEND AN INVOICE TO THE ADDRESS ABOVE

METHODS OF PAYMENT

BANK TRANSFER
Bank transfer must be made in EURO in favour of High Performance Travel srl  to: MONTE DEI PASCHI DI SIENA BANK  - Agenzia Piazza S.Nicolò –  Verona -  account number  24745/48   ABI 01030   CAB 11700  SWIFT PASCIT MM VER
All payments must be free of charges to the receiver.

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CREDIT CARD BY FAX OR REGULAR MAIL
Payment by VISA, American Express, Master Card 
If you wish to pay by credit card please complete the following:

Credit card type 		
Credit card number	Expiry date		
Name of cardholder	Birth date  	                                     

Total amount to be debited	€	

Signature	Date	                                                                   

Please enclose a photocopy of your credit card (front and reverse)

NOTE: REGISTRATION WILL ONLY BE ACCEPTED WHEN THE APPROPRIATE 
PAYMENT HAS BEEN RECEIVED (NO LATER THAN APRIL 24 2003).
YOU WILL RECEIVE A RECEIPT FOR PAYMENT AND 
CONFIRMATION OF REGISTRATION AT THE ADDRESS ABOVE.

Please return forms to:
High Performance Travel Srl
Lungadige B. Rubele 36/38 A  -  37121 VERONA  VR  - Italy
tel 045 8010500 -  fax 045 8010700 

CANCELLATION  POLICY

Cancellations of reservation received after May 15 2003: NO REFUND

INFORMATION

For any additional information on travel arrangement and hotel reservation, you can directly contact High Performance Travel at the address: hptcongress@hpt.it