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REGISTRATION FORM

      First name:*        Last name:*

Sex:* F   M
Occupation:*
Workplace:*
Workplace address:
Country:*
City:* Zip code:*
Street:* No:*
Home address:
City: Zip code:
Street: No:
Telephone / fax at work:*
E-mail at work:*
Telephone / fax at home:
Private e-mail:
I wish to participate at the conference as:*
Invited lecturer Lecturer
Participant With posters
Student Accompanying person
For lecturers:
I need the following technical equipment:
Slide projector
Over-head projector
Power Point facilities
Video player
Title of my lecture/poster:
Participation fees
Please, check the box that refers to you
The accomodation in Alba Iulia and in Şimleu Silvaniei is not included in the price.
  Field trip Conference Total Discounts
Participant 150 € 250 € 400 € If transferred by
February 5, 2011
175 € 275 € 450 € -
Student* 150 € 125 € 275 € If transferred by
February 5, 2011
175 € 150 € 325 € -
Accompanies** 150 € 175 € 325 € If transferred by
February 5, 2011
175 € 175 € 350 € -
Total:
* the price includes the accomodation and supper on the field trip, but does not include the opening reception and the gala dinner (In case you don't require simultaneous translation, the conference fee is 75 €)
**the price includes the opening reception and the gala dinner as well as the accomodation on the field trip but does not include the conference materials or any other conference facilities

Accomodation posibbilities during the conference:
Room Alba Iulia Şimleu Silvaniei
single 30 € / night 30 € / night
double 18 € / person / night 18 € / person / night
Number of nights spent at Alba Iulia:
Number of nights spent at Şimleu Silvaniei:
If you fill out the accomodation request form, the reservation will be booked by the organisers. The prices contain accomodation and breakfast.
I do not need accomodation
Total:
If you have any preferences regarding your room-mate, please let us know:
TOTAL PAYMENT DUE*:
(please sum the green fields)

In order to ease the organisation, please specify the date and means of your arrival and departure:


SPECIAL REQUIREMENTS please indicate your options*
Are you a vegetarian?
YES NO
Others (please specify the foods you can not eat if any):


TERMS OF PAYMENT:
Please transfer the total amount to be paid to the Historic Building Conservationists Society's bank account at least by May 4. The registration fee is 450 euros. (For exceptions, and discounts, please consult the table.)
The organisers are not able to take into consideration demands received after May 2, 2011.

Bank account details:
Account holder's name: Asociaţia Restauratorilor de Monumente Istorice din Transilvania ARMIT
Str. Breaza Nr. 14. 400253 Cluj-Napoca
Name of bank: Banca OTP, sucursala Cluj
Address of bank: RO-400558 Cluj-Napoca, str. Calea Floresti, no. 81
Bank account: RO23 OTPV 2010 0018 7446 EU01 (euro)
SWIFT code: OTPV ROBU

Cancellation policy for Registration:
Cancellation between March and 1, 2011 April 1, 2011 - 50% refund. No refund after 1, April.

Contact details:
Mailing address: RO-400110 Cluj-Napoca, P.O. 1 Po.Box 1176
Tel./fax: +40-264-435 489 / +40-264-436805
Mobil: +40-730-909630, +40-730-909636
E-mail:tusnad@transsylvanianostra.eu
           tusnad2011@yahoo.com
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