For non-speaking participants at the workshop
To the Faculty of Mathematics, Fax number 972-8-9344122
I am a student (yes/no):
I will participate in the conference dinner (yes/no):
If yes. I participate in the dinner with my partner / accompanying person (yes/no):
I will arrange my own accommodation (yes/no):
If no :
Arrival date (____.____). Departure date (____.____).
Please check one of the following (all prices include breakfast):
( ) a room (single occupancy) at 45 $ or ( ) a shared room at 27.5 $ per person per night (Youth Village).
( ) I share my room with my accompanying person or ( ) with another participant of the workshop, if possible with:
( ) hotel or ( ) appartment in Tel-Aviv. Number of persons:
If you wish to stay in a hotel or appartment, please give the following details of your credit card:
Visa/ American Express/ Master Card/ Diners Club (delete as appropriate)
Number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Expiry date: ____.____