REGISTRATION & ACCOMMODATION FORM OR REPLY FORM

Please fill in the appropriate sections and click the submit button.
If You would like to fax it or send it by air mail, Click Here
    
If you plan to send the registration form and payment by airmail please notify the conference secretariat
 * Required fields
A
Surname:*:
Name:*:
Company:*:
Title:*:

Title : Mr. Ms. Dr. Prof.     Wharton Program/ Year

Mailing Address: Work Home

Street :
City : State :
Country : Zip Code :
Tel : Fax :
E-mail :
B
In payment of REGISTRATION FEES: (Please check the appropriate box)

By February 10, 2001 After February 11, 2001 On site Registration
Alumni US$ 375 US$ 450 US$ 600
Accompanying person Participatingin conference US$ 375 US$ 450 US$ 600
Accompanying persons program US $300 US $350 US$ 350
Alumni associates* US$ 450
US$ 550
US$ 700
Students US$150 

Name of Accompanying Person:

*If you are an Alumni associate, please state the name of an Israeli alumni who referred you to the conference :
C
I intend to attend the following track on Tuesday, March 13, 2001:
Track A - TELECOM
Track B - BIOTECH
Track C - SOFTWARE
D
In payment of ACCOMMODATION FEES: (Please check the appropriate box)

I would like to reserve accommodation as follows:
Check-in date: Check-out date: No. of nights:

HOTEL
SINGLE ROOM
(One Person)
DOUBLE ROOM
(Two Persons)
The Tel-Aviv Hilton Hotel
US$200
US$220

Rates are per room, per night and include Israeli buffet breakfast and service charges.
All requests for accommodation must be accompanied by a deposit for one night

If you are interested in accommodation at lower rates, please contact the conference secretariat

The deposit will be transferred to the hotel and the balance should be paid directly to the hotel upon check-out.

To ensure hotel accommodation, please send your reservation to the secretariat, by no later than February 25, 2001. (Reservations received after this date cannot be guaranteed)

Cancellation of Registration / Accommodation:
For Cancellation Policy details please refer to the Cancellation Policy in the General Information.

E

I am interested in booking a POST-CONFERENCE TOUR. Please send me a form:

Tour A
3 day Tour to
Massada/ Dead Sea & Eilat
March 14-17, 2001
Tour B
Half day tour to
Tel Aviv and Jaffa
March 14, 2001
Tour C
Half day tour to Caesarea
March 15, 2001
F
Please state which of the following are your fields of interest:
Health care Professional Services Venture Capital
Telecommunication Software Real Estate
Other

MODE OF PAYMENT:
Check no. for the amount of US$ 
enclosed sent by airmail 


ALL CHECKS SHOULD BE MADE PAYABLE TO:
CARMEL ORGANIZERS OF CONFERENCES LTD.

Please charge my credit card for the amount of US$
Visa Diners Eurocard/Mastercard American Express

Card no.
Name of card owner
Expiry date
Passport no. of card owner
Please make out the receipt to
Date