Registration form the International Conference Olbian Forum 2008: \"Strategies of Ukraine in Geopolitical Space\" June, 5-8th, 2008 Yalta, Crimea, Ukraine icon

Registration form the International Conference Olbian Forum 2008: "Strategies of Ukraine in Geopolitical Space" June, 5-8th, 2008 Yalta, Crimea, Ukraine




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НазваRegistration form the International Conference Olbian Forum 2008: "Strategies of Ukraine in Geopolitical Space" June, 5-8th, 2008 Yalta, Crimea, Ukraine
Дата16.10.2012
Розмір30.74 Kb.
ТипRegistration form

REGISTRATION FORM

The International Conference

Olbian Forum 2008: “Strategies of Ukraine in Geopolitical Space”

June, 5-8th, 2008

Yalta, Crimea, Ukraine




Please complete and return this form to:


Petro Mohyla Mykolayiv State University for the Humanities

vul. 68 Desantnykiv, 10

Mykolayiv, 54003

UKRAINE

Tel: + 380 512 50-03-32 (Vice-rector)

+ 380 512 76-55-99 (Postgraduate Studies Dept.)

+ 380 512 76-55-77 (Dept. of International Affairs)

Fax: + 380 512 500069

E-mail: avi@kma.mk.ua, serhiy@kma.mk.ua, vrector@kma.mk.ua.

Identification__________________________________________ ________



Participant (Please TYPE or PRINT IN BLOCK LETTERS)


Last name Name


Patronymic/ Middle name


Title: Mr.  Mrs.  Ms. Dr.

Accompanying Person____________Yes__________No______________________________________________________




Name of the accompanying person (Please TYPE or PRINT IN BLOCK LETTERS)



_________ ____

Last name Name Patronymic/Middle name

Travel and Hotel Reservation


After the registration by the Organizing Committee you will receive an Agreement Letter (two copies). Upon the receipt of the Agreement Letter with your signature, the Organizing Committee will reserved a place in two-bed room at the sanatorium “Kurpaty”, sector “Druzhba”, for three nights (from 8 a.m., 6/5/2008 to 8 a.m., 6/8/2008) for you and the accompanying person.

For the accompanying person the organization fee is UAH 950.

Upon our receipt of your payment of the participation fee, made either through your institution/organization or personally, the Organizing Committee will send you a Confirmation Letter that will contain information in regards to your hotel reservation.

You may choose to stay longer or participate in non-conference-related activities at your own expense.


Please reserve a hotel for:




Types of lodgings

per night, UAH ($)

nights

together, UAH ($)

registration fee

UAH ($)

together, UAH ($)



Double room, per person (shared room)

300 (60)

3

900 (180)

150 (30)

1050 (210)



Double room (participant and accompanying person staying together)

  • Participant

  • Accompanying person



300 (60)

300 (60)



3

3



900 (180)

900 (180)



150 (30)

50 (10)



1050 (210)

950 (190)



Double luxury suite, per person (participant and accompanying person staying together)

  • Participant

  • Accompanying person



490 (100)

490 (100)



3

3



1470 (300)

1470 (300)



150 (30)

50 (10)



1620 (330)

1520 (310)



Single room in ^ Palmira Palace hotel

from 780 (155)

to 1160 (230)

3

from 2340 (465)

to 4980 (690)

150 (30)

from 2490 (495)

to 5120 (720)



Date and time of arrival Date and time of departure

___/____ (Date) ___ /___ (time) ___ /___ (Date) ___ /___ (time)

Presentation at the conference____________________ _____________________



Yes, I will be presenting No, I will not be presenting


Section # 1 2 3 4 5 6 7 8


Title of the presentation:


I will submit my presentation electronically as:

Power Point presentation,


For my presentation I will require:

Computer with video projector Flip chart (or black board)  overhead projector

Address_____________________________________________ ______________


Please, accurately complete this section: it is necessary the exchange of conference participants’ addresses. Upon the receipt of the completed Registration Form we will provide you with more details with regard to the conference organization no earlier than March 15, 2008

Address:



Institution Department


No. Street Suite/Apt.


City State/Province Postal Code Country


__ ______

Tel. (office hours): Country code/city code/number Fax: Country code/city code/number


__________________________

E-mail


Home mailing address:


______

No. Street Suite/Apt.


City State/Province Postal Code Country


Please send, fax or mail the fully completed Registration Form to the address at the top of the Form.


Thank you very much!


Date ___________________________________


Signature _______________________________

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