Social Program Registration Form

Social Program Registration
Please fill out this form as completely as possible and submit before May 25, 2015
(This form contains interactive fields. You may directly write into the interactive fields with Adobe Acrobat.)
Participant Contact Information
Prof/Dr/Mr/Mrs/Ms
First/Given Name
Last/Family Name
All social events are subsidized by the main sponsor of CEM'15: ABAKUS Computing Technologies. Registration fees indicated here are symbolic and
mainly for the purpose of planning and bookkeeping, not for covering the expenses. Last-minute on-site registration for any social event will be
possible, but not guaranteed, and will incur higher fees.
Participant
Activities
Izmir City Tour
Wednesday
July 01
14:00-18:00
Wednesday
July 01
19:00-21:30
Thursday
July 02
# of Guests
Adults
Kids*
(Please join us for a bus tour of Izmir.)
Fee
€0
Fees: €3 for participants, €6 for adult guests, €2 for kids*.
Welcome Reception
(Kordon Otel Pasaport)
€0
Fees: Free for participants and all guests.
Trip to Cesme and Alacati
13:30-20:30
(Please bring your swim suits. We will go to a beach club and swim in the
Aegean Sea.)
€0
Fees: €5 for participants, €9 for adult guests, €3 for kids*.
Boat Trip
Friday
July 03
14:30-18:30
Friday
July 03
20:00-22:30
Saturday
July 04
Attending?
(Interested guests are welcome to join us for a short boat ride in Izmir Bay
with the public-transportation boats.)
€0
Fees: Free for participants, €3 for adult guests, free for kids*.
Workshop Dinner
(Formal sit-down dinner.)
€0
Fees: Free for participants, €20 for adult guests, €10 for kids*.
09:00-20:00
Trip to Ephesus
(Full-day trip to Ephesus, Terrace Houses, Virgin Mary Church, St.
John Basilica, and Sirince Village.)
Fees: €10 for participants, €20 for adult guests, €5 for kids*.
€0
* Kids: Under 12 years old.
Total Amount:
Euro
Payment Method: Credit card only.
0.00
For these small amounts of payments, we do not prefer bank transfers. However, if bank transfer is the only possible way for you, please contact CEM'15 Secretariat.
Please note that this payment can be combined with the workshop registration fee and the sum of the two can be paid with a single bank transfer or credit card payment.
Credit Card Information
Card Type:
Visa
Issuer of the Credit Card:
Mastercard
(Name of the bank, company, institution, etc. Also, indicate the special
type of the card, if any, such as Maximum, Bonus, Axess, etc.)
Credit Card Number:
Expiration Date:
/
CCV Security Code:
Amount to be charged:
(mm/yyyy)
The last 3 digits printed on the back of the card.
Currency:
(Euro, USD or TL)
0.00
Please write the amount to be charged in letters
to avoid any mistakes.
Euro
I hereby agree to pay the amount indicated above in the currency indicated above to “ABAKÜS Bilişim Teknolojileri Araştırma
ve Geliştirme Müh. Tic. Ltd. Şti.”
Name:
Signature:
Date:
Comments/Requests:
CEM’15 Secretariat
e-mail: [email protected] fax: +90 312 265 0671
CEM’15 Computational Electromagnetics Workshop Social Program Registration
phone: +90 312 265 0670