NANOTUBE 2002

International Conference on the Science and Application of Nanotubes

Boston College (USA)

July 6 - 11, 2002

Registration/Housing Form

This form requests personal information for registration and allows you to reserve on-campus accommodations. The FAX number and address are listed at the bottom of the form.

The registration fee is US$350 (regular) or US$100 (full-time students) before April 30. After April 30, the fee is US$400 or US$150. This fee includes morning and afternoon refreshments, a welcome reception, an evening banquet, booklet of abstracts and NT02 related items and expenses. In order to provide a convenient and secure mechanism for registrants to make payment, we have arranged for the following payments options:

* VISA or Master Card via FAX or regular mail

* Personal check made out to "Boston College" via regular mail. (Checks must be made in U.S.   dollars, drawn on a U.S. Bank. Do not send currency!)

For either payment option, please print the form, fill in and submit the registration and housing form for processing either by FAX or by mail. We'll notify you when your registration form and payment have been received.

First name

Last name

Middle initial

Title

Organization

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Work Phone

FAX

E-mail

Contribution Log#/ID#

P

Are you the presenting author?

(Y/N)

 

Calculate your cost:

Registration Fee:

US$350 (US$100) prior to April 30

US$400 (US$150) after April 30

If you plan to stay in on-campus housing:

No. of accompanying adults and children

Arrival Date: no sooner than Friday, July 5

Departure Date: no later than July 12, 9 a.m

Total Number of Nights

Single or Double Accommodations?

Single=$54.00/night;

Double=$37.00/person/night

Total Accommodation Cost:

Total Cost (Registration and Accommodation)

Payment Type: VISA, MC, check

Enter VISA, MC Card Number

Enter Credit Card Expiration Date

Please sign here:

FAX NUMBER: +1-617-552-8478

Attention: Joan Drane

ADDRESS: NT02 2002 Conference

c/o Joan Drane

Boston College

Department of Physics

140 Commonwealth Avenue

Chestnut Hill, Massachusetts 02467, USA

main nanoten