EGS 2001 - Pre-Registrtation Form

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1. General Information

	Mrs. Ms. Mr. Prof. Dr.
Last Name:
First Name:
Dept./Inst.:
Comp./Univ.:
P.O. Box/Street:
ZIP Code:
City:
Country:
Telephone:
Telefax:
E-mail:

2. Areas of Interest (please indicate your main interest)

Solid Earth Geophysics (SE)
Geodesy (G)
Hydrological Sciences (HS)
Oceans and Atmosphere (OA)

Solar-Terrestrial Sciences (ST)
Planetary and Solar System Sciences (PS)
Nonlinear Processes (NP)
Natural Hazards (NH)

3. Conference Badge (your preference, max. 30 characters)

Name:
Institute:
Country:

4. Registration Fees

Categories	Pre-Registration		On-Site Reg.
	Early Bird Rates *before 31 January 2001*	Normal Rates *before 28 February 2001*	On-Site Rates
EGS Members 2001(¹): EGS Student Members 2001(¹)(*): EGS Retired Scientist Members:	165,- EUR 70,- EUR 70,- EUR	190,- EUR 95,- EUR 95,- EUR	215,- EUR 120,- EUR 120,- EUR
Non EGS Members: Non EGS Student Members(*): Non EGS Retired Scientist Members:	200,- EUR 105,- EUR 105,- EUR	225,- EUR 130,- EUR 130,- EUR	250,- EUR 155,- EUR 155,- EUR
Regular Day Ticket: Student Day Ticket:	On-Site Rate only On-Site Rate only	On-Site Rate only On-Site Rate only	130,- EUR 75,- EUR

(¹)	Participants having paid their annual EGS membership fee for 2001 or Members of the following corporate Societies: American Geophysical Union (only for members with an address in USA or Canada), Danish Geophysical Society, Norwegian Geophysical Society and Swedish Geophysical Society.
(*)	Please enclose/show proof of status.

5. Award Buffet

Yes, I would like to participate in the EGS2001 Award Buffet with person(s) and will add the amount of
35,- EUR each to my registration fee.

6. Conditions and Cancellation Deadline

Pre-Registration must be accompanied by a payment, otherwise it will not be processed. In all other cases the on-site registration fee will be taken as a basis.
We do not send any invoices. We do not accept orders. We do not accept bank transfers.
Registration fees will only be refunded, if the notice of cancellation is received by the EGS Office BEFORE 28 FEBRUARY 2001. The cancellation fee is 50,- EUR. Registration fees are not transferable.

7. Method of Payment

Cheque Payment
Please print out this completed form and send it by mail together with the cheque to the EGS Office, c/o EGS 2001, Max-Planck-Str. 13, 37191 Katlenburg-Lindau, Germany. Cheques will only be accepted if they are written in the currency of the bank to which the cheque is actually drawn and if a cheque fee of 5,- EUR has been added.

Credit Card Payment
Please charge my credit card (only Eurocard/Mastercard/VISA/American Express accepted):
Amount: (only EUR payment accepted):

Card Number:
Valid Until:
Card Holder:

Date:

Name:

to its initial values.
content you specified that will be send.
content to the conference office (egs@copernicus.org).

OR use the "Print" button of your browser if you want to keep a copy and/or to send the form by telefax (+49-5556-4709) or by mail (EGS Office, Max-Planck-Str. 13, D-37191 Katlenburg-Lindau, Germany) rather than online for security reasons.