Instructions: Either print this form, fill it out, and mail or
fax it; or edit the form with an html editor and e-mail it to
kvinson@u.washington.edu (not recommended if paying by check or credit
card).
Name: _____________________________ Gender:
F M
Address: _____________________________________
_____________________________________
City:
____________________________ State or province: __________
Postal code: _________
Country: _________
Telephone: Country code _____ tel.
_______________ fax. ______________
E-mail address: __________________________________
| fee - USD | ||
| Early
registration: before 15 April |
160 | [] |
| Regular
registration: April 16 to June 14 |
210 | [] |
| Developing
country* participants by June 14 |
no charge | [] |
| Participants
from transitional countries** by June 14 |
60 | [] |
Hotel reservation
Please check one:
[] I have made hotel reservations already.
[] I will make hotel reservations by 10 May (conference
participants are required to stay at Eibsee Hotel).
[] I would like to share a room to reduce costs; please assign me
a roommate.
[] I require a letter of support to obtain a
visa
Attach a paragraph describing your duties in your organization and how
you would benefit from participating in SICCIA. Also, please send the
address and/or fax to which the letter of support must be sent.
send completed registration form to
SICCIA
attn. Kathryn Vinson
Climate Impacts Group
Box 354235
University of Washington
Seattle, WA 98195 USA
kvinson@u.washington.edu
+1 (206) 616-5775 (fax)