71st MPEG meeting registration forms
17-21 January 2005
Hong Kong, China
MEETING REGISTRATION FORM
Given name (s):
Family name (s):
City & postal code:
¨ Early bird (on or before 15 Dec 2004) registration fee is 2,750 HKD (approximately 350 USD)
¨ Regular (after 15 Dec 2004) registration fee is 3,000 HKD (approximately 385 USD)
¨ On-site registration fee is 3,200 HKD (approximately 410 USD)
I ¨ will ¨ won’t attend the social event on the evening of Wed, 19 Jan. 2005.
Additional cruise buffet dinner ticket is 500 HKD each (approximately 60 USD).
Number of additional cruise buffet dinner ticket needed is __________.
Credit card: Type: ¨ VISA ¨ MASTERCARD
Expiry date (mm/yy):
I hereby authorize Hong Kong University of Science and Technology to charge on the above credit card
account a total amount of _______________________ HKD (non-refundable).
Signature: _____________________________________ Date: ____________________________
Please fax the signed registration form to: Ms Iris Ting, EEE, HKUST, Hong Kong.
Fax no: +852 2358-1485 . For any questions: please contact email@example.com