26-30 October 1998 Goa, India
REGISTRATION FORM
IGCP Project no. 396 'Continental shelves in the Quaternary' 3rd Annual Conference, October 26-30, 1998, Goa, India
Please complete and return with payment to arrive in Goa by July 31, 1998
Title Prof [ ] Dr [ ] Mr [ ] Mrs [ ] Ms [ ]
Name and initials ________________________________________
Address___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Country ________________________________
Phone __________________________________
Fax ____________________________ E-mail _____________________________
I wish to attend the archaeological excursion
Yes [ ] No [ ]
I have enclosed a paper for an oral session*
Yes [ ] No [ ]
If yes, the title is
___________________________________________________________________________
___________________________________________________________________________
I have enclosed a paper for a poster session
Yes [ ] No [ ]
If yes, the provisional title is
____________________________________________________________________________
____________________________________________________________________________
If you are an overseas participant, please give details of your passport (this >is required by the Government of India for participating in an official >meeting)
Passport no. ___________________________
Issuing authority ___________________________
Place of issue ___________________________
Date of expiry ___________________________
Date of birth ___________________________
My accommodation requirements are (please tick and/or complete)-
Hotel Cida de Goa [ ] Hotel Prainha [ ] International Centre [ ]
I am making my own accommodation arrangements Yes [ ] No [ ]
I will be accompanied by my spouse: Yes [ ] No [ ]
I would like to share a room Yes [ ] No [ ]
if Yes with ___________________________________
[ ] I have enclosed a bankdraft for the sum of US$ _____________
[ ] I have enclosed a demand draft (for Indian delegates) for the sum of Rs. ____________
__________________________________________________________________________
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Copyright© National Institute of Oceanography,
Goa, India .
Updated last on 20th April '98.