ACTIVE 97 (1997 August 21-23)

INTER-NOISE 97 (1997 August 25-27)		 Send it to:
Symposium / Congress Secretariat
OPAKFI
H-1028 Budapest, Fõ u. 68., Hungary
Tel/fax:+36/1-201-8843 or
+36/1-202-0452

SYMPOSIUM / CONGRESS REGISTRATION FORM

PLEASE REGISTER ME FOR

ONLY ACTIVE 97 ONLY INTER-NOISE 97 BOTH ACTIVE 97 AND INTER-NOISE 97
Family Name: First Name: Mr: Ms:
Company:
Address:
City:Postal Code:Country:
Phone:Fax:E-mail:

Please complete the applicable portions of the fee schedule below.

Regular (non student) participants, who register for both ACTIVE 97 and INTER-NOISE 97 (lines 1 and 4, respectively) may take a USD 100 deduction (line 8) on the total amount paid.
1.ACTIVE 97 registration fee
Registration fee after 1997 June 1		(USD 380)
(USD 410)		$
2.ACTIVE 97 Registration fee for Students (USD 190)$
3.ACTIVE 97 Registration fee for Accompanying Person

name: .................................................................		(USD 50)$
4.INTER-NOISE 97 registration fee
Registration fee after 1997 June 1		(USD 400)
(USD 450)		$
5.INTER-NOISE 97 Registration fee for Students (USD 200)$
6.INTER-NOISE 97 Registration fee for Accompanying Person

name: .................................................................		(USD 60)$
7.SUBTOTAL (USD 380)$
8. If attendee registration fees for both ACTIVE 97 and INTER-NOISE 97 have been listed, deduction (- USD 100)$
9.TOTAL DUE (USD 380)$

Vegetarian food for participant for accompanying person



METHOD OF PAYMENT

Bank transfer (copy of bank receipt enclosed)

Account number: KHB 10404089-40899979-00008885

(Commercial and Credit Bank, H-1056 Budapest, Váci u. 40, Hungary)

Cheque payment drawn in favour of OPAKFI (H-1027 Budapest, Fõ u. 68, Hungary) enclosed

Signature
....................................................................

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