Hotel Reservation Form for ICMP
A Satellite Meeting of the World Congress 2006
-Seoul, South Korea

Hangzhou, China
September 3 - 6, 2006

 

Name:___________________________ _______________________
Mr. Ms.            (family name)                                     (given name)

Institution:____________________________________________________________________

Address:_____________________________________________________________________

_________________________________________________ Postal code:_________________

Telephone: _______________________________ Fax:________________________________

E-mail: _________________________________________________ Please print clearly

Please specify room type: Standard / Deluxe / Deluxe Suite  (please circle one)

                                           Smoking / No-smoking  (please circle one)

Arrival date: _________________________    Departure date: ________________________

The number of rooms are limited and are available on a first come first served basis.  If not
available, the next available lower grade room will be reserved for you.   Please mail a deposit
check in the amount below which is approximately the first night's room rate.


Deposit amount:      Standard Room:         US$ 60                             
                                 Deluxe Room:            US$100                   
                                 Deluxe Suite:              US$120                 Enclosed US$     ____________ 

*Refund Policy: Before August 10, 2006, full refund.
After August 10, 2000, no refund will be made.
 

Please print this page using your local printer

Checks should be made payable to North American Chinese Medical Physicists Association,
or NACMPA

Please email a note to RayKWu@GMail.com for record, and

mail Reservation Form and check to:

Haoran Jin, Ph.D.
NACMPA
PO Box 721222,
San Diego, CA 92172
USA

For questions please contact:
Haoran Jin, Ph.D.
email: ljmedphys@hotmail.com

phone: 619-230-0400

or
Raymond Wu, PhD
email: RayKWu@GMail.com
phone: 614-566-4427

 

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Last update: July 17, 2006

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