Western Section American Society of Animal Science

7th International Symposium on Grapevine Physiology and Biotechnology University of California, Davis June 21-25, 2004 ADVANCED REGISTRATION FORM Registrant Information Three Ways to Register A separate form is required for each registrant. (Please print legibly or type)

Register On-Line Name: Http://conferences.ucdavis.edu Last First MI (Click on Academic) Affiliation: Credit Card Payments Only Address: Register by FAX Street Address Complete this form and FAX to (530) 752-5791 City State Zip Code Country Credit Card Payments Only Phone: ( ) Fax: ( ) Please include area, city and country codes Please include area, city and country codes Register by Mail Email: Mail completed form and Required for confirmation purposes payment to: Conference & Event Services Registration Fees Registration forms must be received by June 11, 2004 University of California After this date, registration will need to take place on-site at the higher registration fee One Shields Avenue th th 442 Memorial Union Registration Fee Per Person By May 14 As of May 15 Totals Attn: Grapevine ISHS Member $360 $410 $ Davis, CA 95616 Non- ISHS Member $385 $435 $ Student Registration1 (Fax Proof to 530-752-5791) $200 $225 $ Cancellation Policy All cancellation must be Banquet (6/24/04) $30 x ______$ received in writing no later Total $ than Friday, June 4, 2004. Companion/Guest Tours Cancellations received after Last day to register for tours is Jun 4, 2004. Friday, June 4, 2004 will not San Francisco Bay Cruise (6/25/04) CLOSED DUE TO LOW ENROLLMENT be processed. Cancellations Name of paid guest: received prior to this date and time are usually processed Lake Tahoe Tour (6/22/04) CLOSED DUE TO LOW ENROLLMENT after the conclusion of the Name of paid guest: Total $ conference and will be Tours may be cancelled due to low enrollment. If tour is cancelled, payment will be refunded. refunded minus a $40 Conference Questions administrative processing fee. Do you have any special dietary needs? (ex: food allergies, vegetarian, vegan, etc) Yes No Mail Cancellations to: Please Explain: Conference & Event Services University of California Payment Information One Shields Avenue Enclosed is my check/money order made payable to "UC Regents" 442 Memorial Union Attn: Grapevine UC Davis DAFiS or UC Campus Recharge (please include Acct , Sub Acct, Dept, Acct Manger and Phone) Davis, CA 95616 VISA MasterCard American Express Discover

Credit Card Number Expiration Date

Name of Card Holder (as it appears on card) Signature of Card Holder Registration Confirmation: Once your registration form has been processed, you will receive confirmation by email. If you have not received an email confirmation ten business days after submitting your registration form, please contact Conference & Event Services at (530) 752-0198 or [email protected] to inquire on whether your registration form was received

1 Proof of full-time student status required