Registration Form

International Ab-Sorption Heat Pump Conference '96
17 - 20 September 1996
Le Centre Sheraton, Montréal, Québec, Canada

Please print out this page, complete it and send to the address/fax indicated below.

Name (to appear on badge) Last Name, First Name

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Title (to appear on badge) Prof., Mr., Mrs., Ms.

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Company/Institution

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Address

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City and Province

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Country and Postal Code

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Telephone and Facsimile

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$500 Cdn. Early registration fee (by July 19, 1996)
$600 Cdn. Full registration (after July 19, 1996)
$700 Cdn. On-site registration
$100 Cdn. Spouse and Student Registration

Total Registration fees (must be in Canadian funds)                Sub-Total:    $_______ (1)

Additional Banquet tickets for                       ____ person(s) x $50 Cdn. = $_______ (2)

Pre-Conference tour for                              ____ person(s) x $50 Cdn. = $_______ (3)

Pre-Conference workshop for                          ____ person(s) x $50 Cdn. = $_______ (4)

Total Enclosed (1+2+3+4)   : $__________

<> Enclosed is my check for  $__________  (In Canadian funds only) payable to: Ab-Sorption '96

<> Please charge to my credit card (circle one):

American Express / Master Card / Visa


Name on card (print)     ___________________________________________

Card Number              ___________________________________________

Expiry Date              ___________________________________________

Signature of cardholder X___________________________________________

Please send to:
John Kotchan
Ab-Sorption '96 Secretariat
c/o JPdL Multi Management Inc.
1410 Stanley, Suite 609
Montréal, Québec
Canada H3A 1P8

Facsimile: +1-514-287-1248

Design & Hosting: RTM Communications

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