CALOR99 - VIII International Conference on Calorimetry in High Energy Physics June 13-19, 1999 Lisbon, Portugal ----------------------------------------------------------------------------- SHORT REGISTRATION FORM - I have registered by e-mail or through the web form ----------------------------------------------------------------------------- IDENTIFICATION -------------- FAMILY NAME: _____________________________________________________ FIRST NAME: _____________________________________________________ INSTITUTION: ___________________________________________________ ADDRESS: ___________________________________________________ ___________________________________________________ E-MAIL: ___________________________________________________ PHONE: ___________________________________________________ FAX: ___________________________________________________ (TYPE AN "X" IN THE SPACE CORRESPONDING TO YOUR CARD) I pay the conference fee by CREDIT CARD: ___Visa ___Eurocard ___Mastercard ___American Express Credit card number: _____________________________________ Credit card name: _____________________________________ Expiry date (e.g. 11/99): ____/____ Signature: _____________________________________________ PRINT and send by FAX or LETTER to LIP - CALOR99 Av. Elias Garcia, 14 - 1 1000-149 Lisboa Portugal FAX: +351-1-7934631