PERSONAL DETAILS

Surname (Last name): 

First name ........: 

Institution .......: 

Address ...........: 
(please, include street, PO Box, city, postal code, State and country)

Phone .............: 

Fax ...............: 

E-mail Address ....: 



I WOULD LIKE TO GIVE A PRESENTATION: 

            No     :  
            Oral   :  
            Poster : 
       Oral or  poster : 
       Oral and poster : 

CONTRIBUTION TITLE(S): 
If you wish to present a (or several) contribution(s), please fill in
the abstract form before July 10th, 1999.



SOCIAL EVENTS
Please, tick the events you wish to attend and indicate the number of
persons that will be accompanying you.

SUNDAY, October 3rd
  17:00 - 20:00  Reception and wellcome cocktail at the Conference Center
   (free of charge) 
   Number of accompanying persons 

WEDNESDAY, October 6th
  13:30  Teide National Park and Observatorio del Teide at Tenerife   
   (1,000 ptas per person)
   Number of accompanying persons 

THURSDAY, October 7th
  20:00  Conference banquet (5,000 ptas per person)
   Number of accompanying persons 

SATURDAY, October 9th
  06:30  Observatorio del Roque de los Muchachos at La Palma
   (20,000 ptas per person) 
   Number of accompanying persons 
 OR
 10:00  Teide National Park and Observatorio del Teide at Tenerife
   (1,000 ptas per person) 
   Number of accompanying persons 



COMMENTS: please, indicate diet needs and/or other comments



***** PAYMENT SHEET *****

(30,000 ptas early registration fee - before July 10th; 40,000 ptas late
registration fee; 20,000 ptas early registration fee for students;
no registration fee for accompanying persons).


We remind you that $US 1 ~ 140 ptas.


Please, tick one out of the three options:

 1) Credit card (VISA, Mastercard/Access) .......: 
    Card number ...: 
    Expiry date ...:   (dd/mm/yy)

    Please, indicate here the *name on the credit card* if it is different
    to the registrant's name:
    

 2) By cheque in pesetas made payable to the
    Instituto de Astrofisica de Canarias, IAC ...: 
    Via Lactea s/n
    38200 La Laguna, Tenerife, Canary Islands
    Spain

 3) Bank transfer to the following account ......: 
       Instituto de Astrofísica de Canarias (IAC)
       Banco Bilbao Vizcaya      (this is the bank name)
       C/. Obispo Rey Redondo, 25
       E-38291 La Laguna, Tenerife, Spain

       Bank: 0182;  Branch: 0772;  Sorting code: 45;
       Account number: 0000 134741

Please, enter relevant amounts you are paying at this stage:
   Registration fee:  ptas
   Social events:     ptas

Before submitting this form, please check it!