ADG 2006

REGISTRATION
=============
 Name:
 Last Name:
 Institution:
 Department:
 Post Address;
 City:
 ZIP Code:
 Country:
 E-Mail Address:
 Phone:
 Fax:

 Student (please specify: graduate, post doc (date of ph.d.)):
Apply for partial financial support (yes/no): 
Payment:  Cash on site / Bank transfer (free of addicional charge).

Remarks:



 LODGING RESERVATION
======================
 The organization will book a room for you if requested.
 There are some rooms reserved for workshops participants in the following three hotels

 - Hotel Rias Bajas ***
 - Hotel Galicia Palace ****
 - Hotel Residencia A Peregrina **

 The reservations for Hotel Rias Bajas have to be made directly via its web page (see Lodging Section).

 Request for reservation by the organization in Hotel Galicia Palace or Hotel Residencia A Peregrina (to be filled in only if reservation requested. Credit card information necessary)

 Arrival date:
 Departure date:
 Hotel: 
 Room: (single / double)

 Credit card: Visa / Mastercard / Other (specify)
 Credit card number:
 Expiration date (mm/yy):
 Credit card holder name:

You can send this form by e-mail (adg2006@uvigo.es) or by fax (+34 986 801 907). In case you send us your credit card number, perhaps it is better to send it by fax.

In case of no presentation, the hotel could charge the card with one night