Registration Form

Please complete this form and press submit (note that the connection directly to Israel needs to be made)
Please complete this section accurately, the information you provide will allow us to correspond with you efficiently, and it will also be used for your delegate badge at the Congress.


First name 
Title      Prof. Dr. Mr. Mrs. Ms.


Mailing Address

No. Street City State/Province Country Postal Code Telephone (Country code/city code/number) Fax E-mail

Accompanying persons

List only those individuals registering for the Accompanying Persons' Program Surname First Name Title Surname First Name Title Surname First Name Title

Registration Fees

Please check appropriate box/s Until May 15,1996 From May 15,1995 Participant US $400 US $450 WATOC Member US $370 US $420 Student US $100 US $100 Accompanying Person/s US $150 US $150 X No. Banquet US $50 US $50


Please indicate amount enclosed: Method of Payment Option 1: Credit Card Visa MasterCard Diners American Express Card No. Exp. date month year Cardholder Surname First Name Option 2: Bank Transfer Indicate your name and address on the reverse of bank transfer. If payment is made for more than one person or by a company please make sure all names are indicated and send a copy of the bank transfer. Please make drafts payable to: "WATOC '96" and send them to Bank Leumi Le'Israel, Gan Hair Branch, Tel-Aviv, Israel. Account number 816-56027/73 Patam. Bank charges are the responsibility of the payee and should be paid at source in addition to the registration fees. Option 3: Cheque made payable to: WATOC 96 Please send cheque to: Secretariat WATOC 96 P.O.Box 50006, Tel-Aviv 61500 Israel

Cancellation policy

Refund of Registration Fees will be made as follows:
Post-marked prior to May 15, 1996 - full refund less US $40 handling fee
Post-marked from May 15 until June 7 - 75% refund
Post-marked after June 8 - 50% refund