Please complete and email these forms by 11 May, 1998, to: ngstconf@eso.org or fax them to: Institut d'Astrophysique c/o Denise Caro Avenue de Cointe, 5 B-4000 Liege, Belgium Tel: +32-4-2529980 Fax: +32-4-2527474 -------------------------------------------------------- The Next Generation Space Telescope: Science Drivers and Technological Challenges, 34th Liege Astrophysics Colloquium (NGST-LIAC 98) Liege, Belgium, June 15-18, 1998 -------------------------------------------------------- REGISTRATION FORM -------------------------------------------------------- LAST NAME: FIRST NAME: TITLE: INITIALS: AFFILIATION (for name badge): INSTITUTE: DEPARTMENT: STREET: CITY: POSTAL CODE: COUNTRY: TELEPHONE: TELEFAX: E-MAIL: -------------------------------------------------------- REGISTRATION -------------------------------------------------------- ____ I will attend the conference The conference fee of BEF 4000 has been paid ____ by cheque (mailed on ______________ ) ____ by bank transfer (on ______________ ) ____ I wish to pay the conference fee with the following credit card: Card number _______________________ ____ VISA ____ MasterCard Card expiration date _______ Amount to be charged : BEF 4000.00 Name and address of cardholder: _____________________________________ _____________________________________________________________________ Date and signature of cardholder: ___________________________________ -------------------------------------------------------- ____ I wish to present a poster with the following title: ________________________________________________________ The abstract should be emailed separately to ngstconf@eso.org. -------------------------------------------------------- COMMENTS: -------------------------------------------------------- -------------------------------------------------------- ACCOMMODATION REQUEST FORM -------------------------------------------------------- LAST NAME: FIRST NAME: Please make the following room reservation: Date of arrival: Date of departure: ____ Single room ____ Double room (to be shared with ___________________) My hotel preference is ____ Mercure ____ Holiday Inn ____ Comfort Inn l'Univers ____ University Sport Center: a room for ____ persons (to be shared with _____________________________________________________ _____________________________________________________ _____________________________________________________ ) Room rates for the respective hotels are given in the Second Announcement. ACCOMMODATION REQUESTS MUST BE SUBMITTED ON OR BEFORE MAY 11, 1998. After that date, availability of rooms cannot be guaranteed. -------------------------------------------------------- COMMENTS: --------------------------------------------------------