IBA 2010 - Georgia
Registration Form

PLEASE NOTE
Our Online Charging System Accepts Visa and MasterCard ONLY
Out of Visa types: Classic, Business, Gold and Platinum ONLY
Out of MasterCard types: Standard, Business, Gold and Platinum ONLY

*Mandatory Field
Personal Information
First Name*
Last Name*
Title*
Institution*
Address*
Postal Code*
City*
Country*
Phone Number*
(Please indicate daytime phone number with country and area or mobile operator codes)
Fax*
E-mail*
Accompanying person(s)*
Do not leave blank, please type NONE if so
Arrival Date (date/month/year)*
Departure Date (date/month/year)*
Social Events
For planning purposes please mark the box if you will attend the Gala Dinner
Special Instructions
Dietary requirements (please mark the corresponding box below)
Vegetarian
Kosher
None

Other (please specify)



Other special requirements (please specify)







Registration Fees

NOTE ON CANCELLATION AND REFUND POLICY
All requests for refunds must be received in writing by fax (+995 32 53 71 24) to Levan Butkhuzi. Cancellations made before May 1, 2010, will receive a full refund (less €20.00 processing fee). No refunds will be given for cancellations made after May 1, 2010.
  EARLY LATE
Full registration € 220 € 370
Spouse registration € 130 € 280
Student registration
PLEASE, make sure to provide us any legal document from your university, indicating that you are a student 		€ 115 € 165
Extra ticket for Gala Dinner € 40  
     
Field trip € 20 - Borjomi-Kharagauli National Park
€ 20 - Kazbegi Area
€ 10 - Historical-cultural places near Tbilisi
€ 20 - Wine Cellar
Field trip persons
Total €

Please check the information you filled in the form and click "Proceed to Payment" button below;
The system will automatically send two e-mails: one for you and one for the conference organizers.
PLEASE BE CAREFUL: TO AVOID MULTIPLE CHARGING PRESS THE "PROCEED TO PAYMENT" BUTTON ONE TIME ONLY