Fifth International Symposium on Eastern Mediterranean Geology Second Circular

Introduction The Organising Committee cordially invites you to participate in the Fifth International Symposium on Eastern Mediterranean Geology (5th ISEMG) in Thessaloniki, Greece from April 14 to April 20, 2004. 5th ISEMG is organised by the Department of Geology of the Aristotle University of Thessaloniki. The Symposium will be held at the premises of the University of Macedonia, 156 Egnatia Street, Thessaloniki, Greece. The Symposium is being held in parallel with the 10th International Conference of the Geological Society of Greece at the same time and venue – a single entry fee allows participation at both conferences (excluding abstract volumes and proceedings).

Aim The aim of the 5th ISEMG is to further develop the themes initiated in the previous four ISEMG Symposia and encourage the exchange of new ideas. Recent advances in the earth sciences that have arisen from or relate to research in the broader eastern Mediterranean region are welcome. The Eastern Mediterranean is one of the most interesting and active research areas in the world. At present, the African plate is being subducted beneath Eurasia one, structural activity is on-going along the extensive North and East Anatolian fault zones, the Jordan-Lebanese Fault, the Arabian Plate, and the Red Sea Rift. These and other structures constitute a unique geodynamic environment where the full spectrum of earth-forming phenomena may be observed. The main objectives of this meeting are:  To bring together researchers from different countries and backgrounds and to exchange ideas and novel research results in an interdisciplinary atmosphere.  To address the broader eastern Mediterranean area as an integrated space, in which all aspects of the geosciences are interrelated.  To promote innovation transfer in selected fields of geosciences, focusing on the broader eastern Mediterranean area.  To contribute towards bridging the gap between North and South, as well as between East and West in terms of research potential.  To collect the extended abstracts of the presentations (short papers) into an internationally distributed volume.  To publish selected papers in prestigious high-impact journals, contributing thus to the general advance of geosciences.

www.geo.auth.gr/5thISEMG Fifth International Symposium on Eastern Mediterranean Geology – Second Circular

Scientific Programme The 5th ISEMG programme includes three days of oral and poster sessions (15-17 April, 2004) and four days of field trips (14 and 18-20 April, 2004). The scientific programme has been organised into two broad groups: thematic Topics and Special Symposia of specific interest: Topics No Title Conveners T1 Structural Geology, Stratigraphy and D. Mountrakis (GR) A. Robertson (UK) Tectonics of the Eastern Mediterranean T2 Petrology and Geochemistry G. Christofides (GR) G. Pe - Piper (CA) T3 Volcanology and Geothermy M. Fytikas (GR) Y. Savascin (TR) T4 Ophiolites in the Eastern Mediterranean A. Rassios (GR) H. Morisseau (CY) (Session dedicated to Alan Smith) T5 Large Earthquakes in the Eastern G. Papadopoulos (GR) B. Ranguelov (BG) Mediterranean T6 Eastern Mediterranean Marine Geology G. Ferentinos (GR) W. B. F. Ryan (USA) T7 Remote Sensing and Natural Hazards A. Ganas (GR) S. Salvi (IT) T8 Vertebrate Palaeontology G. Koufos (GR) S. Sen (FR) T9 Geoarchaeology E. Mariolakos (GR) W. Eder (FR) T1 Mineral Resources N. Skarpelis (GR) S. Strashimirov 0 (BG) T1 Geology of Balkan peninsula S. Karamata (SE) S. Shanov (BG) 1

Special Symposia N Title Conveners o S1 Neotectonics and Basin Analysis T. Doutsos (GR) Z. Garfungel (IL) S2 Earthquake-Induced Ground Effects R. Caputo (IT) I. Stewart (UK) S3 Palaeomagnetism and the Structure of D. Kondopoulou (GR) A. Moris (UK) Eastern Mediterranean S4 Geotopes – Geological and N. Zouros (GR) G. Martini (FR) Geomorphological Heritage S5 Eastern Mediterranean small - scale D. S. Kostopoulos (GR) M. Fortelius (FI) Palaeogeography in relation to Tectonics and Climate S6 Environmental Geology and Infrastructures B. Christaras (GR) P. Marinos (GR) S7 Groundwater Quality and Management in G. Soulios (GR) H. Hoetzl (D) Eastern Mediterranean

Organising Committee Chairman Prof. Spyros Pavlides [email protected] Vice - Chairman Prof. George Christofides [email protected] General Secretary Ass. Prof. Nikos Zouros [email protected] Executive Dr. Alexandros Chatzipetros [email protected] Secretary Treasurer Dr. Panagiotis Tsourlos [email protected] Members Prof. Michael Fytikas [email protected] Prof. George Koufos [email protected] 2

Dr. Dimitris S. Kostopoulos [email protected] Dr. Athanasios Ganas [email protected] Dr. Anne Rassios [email protected]

Honorary Scientific Committee Akinci, Omer (Isparta - Turkey) Ambraseys, N. (London - UK) Arvin, M. (Kerman - Iran) Cisternas, Armando (Strasbourg - France) de Bonis, Louis (Poitiers-France) Dermitzakis, Michael (Athens - Greece) Dramis, Francesco (Rome - Italy) Filippides, Anestis (Thessaloniki - Greece) Flexer, Akiva (Tel Aviv - Israel) Karakhanian, Arkady (Yerevan - Armenia) Karamata, St. (Serbia) Kelling, Gilbert (Keele - UK) Makropoulos, Kostas (Athens - Greece) Marinos, Paul (Athens - Greece) Marto, Andrea (Albania) Papazachos, Basil (Thessaloniki - Greece) Panagides, I. (Cyprus) Perparim Hoxha (Albania) Petrides, George (Cyprus) Piper, David (Canada) Poisson, Andre (Paris - France) Salah El – Hadidy, Aly Youssef (Cairo - Egypt) Tarawneh, Eng Khaled (Amman - Jordan) Trifonov, Vladimir (Moscow - Russia) Tutkun, Zeki (Çanakkale - Turkey)

Language The official language of the Symposium will be English. No simultaneous translation will be available.

Presentation Modes There will be oral and poster presentations in all sessions (15-17 April, 2004). The Organising Committee particularly encourages poster presentations, as well as research results presented by young scientists1. There will be special awards for young scientists presenting their research results in poster mode. Participants will be able to choose their preference (oral or poster) in the application form, but their definite mode of presentation will be decided by the Organising Committee and the respective Conveners, according to importance of the research results and space / time limitations. Detailed guidelines for preparing oral and poster presentations will be posted in the Symposium’s web site.

1 Young scientists are considered researchers of up to 35 years of age at the time of the Symposium, typically of postdoctoral or postgraduate status. 3

 Oral Presentation – The length of oral presentations will be 15 minutes. At the end of each oral session there will be time allocated for questions and discussion. Invited speakers’ presentations of 20 or 30 minutes length will be selected by the Organising Committee and will open every session. Slides, overhead projectors and data projectors will be available. Speakers are encouraged to prepare data and make presentations using Microsoft PowerPoint software.  Poster Presentation – For each poster, individual freestanding display boards will be allocated. Poster sessions will include a short 3-minute oral presentation of the main points, including two or three slides. The Organising Committee encourages young researchers to give their presentations in poster mode. Leading poster presentations will be awarded.

Short papers The Organising Committee will publish an extended abstract volume plus a CD - ROM including all presentations in the form of short papers (extended abstracts). They should be no less than one and up to four printed A4 pages. Each extended abstract can include figures and should include references. Each registered participant may present up to two extended abstracts as an author or co-author. Furthermore, each accepted presentation should correspond to the registration of at least one of the authors. Each contribution must be submitted under only one of the topics or special symposia. Authors should download and use the template available at the symposium’s web site. The template can also be sent by e-mail to individuals upon request. If an abstract exceeds four pages, it will be returned to the authors for editing within a set deadline. Colour figures will be available only in the CD - ROM edition. Authors should send their extended abstracts (short papers) electronically to the Organising Committee ([email protected]), taking into account the respective deadline (November 30, 2003). No extension to the existing deadline will be granted. The Organising Committee will assign a unique reference number to each abstract which will then be forwarded to the respective Conveners who will review the abstracts and decide on their quality and originality. The Conveners will then suggest their presentation mode (oral or poster) based on the author’s preferences and on the importance of research for the given session. Only abstracts submitted electronically and meeting the requirements will be processed. No hard copies or camera-ready versions will be accepted.

Full papers The Organising Committee will not publish full proceedings of the presentations. However, Conveners will compile special volumes of selected papers to be published in international journals of their respective field of interest. Delegates wishing to publish full papers should therefore contact directly the respective Conveners.

Parallel events Several events are being scheduled to run parallel to the symposium. Up to the time of printing the Second Circular (June 2003), the following events will be held:  Under session T7 (Remote Sensing and Natural Hazards), co-sponsor’s PCI staff will give a demonstration on DEM construction from satellite data using OrthoEngine v9.0, which will be free to all session participants  Under the same session, co-sponsor RSI Italia will organize a one-day training class on the use of ENVI3.6 for spectral analysis of geological surfaces. The RSI Italia training class is limited to 20 people. Sign up is on a first-come, first-served basis. The class is not included with registration. Participants wishing to attend the training class must register for at the conference. 4

Further information on parallel events will be available at the Symposium’s web site, as they become available.

Registration Fees and Payment In order to have their payment processed, the participants will have to complete and sign the Registration and Remittance form (Form A), and send it to the Symposium’s Treasurer The registration fees are as follows: Registration fees Category Before October 31, November 1, 2003 – After February 1, 2003 (advance) January 2004 and on-site 31, 2004 Professional € 110 € 130 € 150 Student2 € 90 € 90 € 90 Registration fees for participants include: Symposium attendance, extended abstracts volume and social events. Registration fees can be paid in any of the following ways:  Bank transfer. In case of a bank transfer, the following account should be used: Account No. 5202-002154-676, Piraeus Bank S.A., Aggelaki, Thessaloniki Branch (2202), 18 Aggelaki St., 54621, Thessaloniki, Greece. SWIFT code: PIRBGRAA, IBAN: GR250172202000520200254676. In this case, a copy of the transaction should be sent by mail, fax, or e-mail to the Symposium Treasurer: Dr. Panagiotis Tsourlos (5thISEMG), School of Geology, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece. Fax: +30 (231) 09.98.528. E-mail: [email protected].  Cheque. A bank cheque should be made payable to the Symposium Treasurer Dr. Panagiotis Tsourlos and sent by registered mail to the same address mentioned above. Personal cheques are not accepted.  Credit card. The Symposium will accept credit card (VISA or MasterCard) payments. Delegates wishing to pay by credit card should fill their card information and sign the Registration and Remittance Form (Form A), which should be sent by postal mail or fax to the Symposium’s Treasurer.

Cancellation Policy All requests for cancellations must be made in writing to the Executive Secretary of the Symposium. Cancellation fees apply as follows:  Before October 31, 2003: full refund.  Before January 31, 2003: 25% cancellation fee (75% refund).  After January 31, 2003: 100% cancellation fee (no refund).

Field Trips and Tours One pre - and three post - symposium field trips as well as two general interest tours will be organised (a minimum of 15 participants is required for the tours to operate). Participants interested in the field trips and tours should complete the Hotel Reservation and Field Trip Booking Form (Form B). All payments regarding field trips and tours should be directed to Charioteer Travel (see Form B for details). Please note that the prices quoted here may be subject to change. Consult the Symposium’s web site for latest information. Field trip registrations will be accepted after January 1, 2004.  F1: Mygdonia basin (14 April 2004).

2 Students (either graduate or postgraduate) must provide a valid student ID to be entitled to the reduced fees. A photocopy of the ID must be included with the registration form. 5

 Topics: Active tectonics (1978 earthquake normal fault zone), stratigraphy (Mygdonian and pre-Mygdonian lithostratigraphic units), geothermy (Nea Apollonia geothermal field), general geology (Circum-Rhodope belt and Serbomacedonian Massif).  Route: Thessaloniki – Stivos – N. Apollonia – Arnea - Thessaloniki.  Leaders: G. Syrides, N. Kolios and A. Chatzipetros  Price: € 30 per person.  F2: Western Macedonia (18 – 19 April 2004).  Topics: Vourinos – Pindos ophiolitic complex (general geology, stratigraphy, structural geology, ore geology), Meso-Hellenic Trench (contact structures, flysch), Kozani – Servia Neogene basin (Ptolemais lignite centre), engineering geology, (Egnatia highway construction), active tectonics (1995 earthquake), palaeontology, archaeological interest sites.  Route: Thessaloniki – Veria – Ptolemais – Servia – Siatista – Vourinos – Grevena – Pindos – Acdella – Samarina – Thessaloniki.  Leaders: A. Rassios, T. Doutsos and A. Georgakopoulos  Price: € 120 per person.  F3: Eastern Macedonia – Thrace (18 – 20 April 2004).  Topics: Western Chalkidiki ophiolite complex (general geology, structural geology, ore geology), Vertiskos – Kerdyllia formation, Olympias – Madem Lakkos – Varvara Au/Ag, Mn ore deposits, Skouries porphyritic copper ore deposit, paleontology (Petralona cave), structural geology (Sidironero), cultural interest sites (Mount Athos, Stagira, Phillipi).  Route: Thessaloniki – Vavdos – Petralona – Porto Koufo (lunch) – Gomati - Ouranoupolis – Mount Athos – Megali Panagia (overnight stay) – Stagira – Stratoniki – Olympias – Kavala (overnight stay) – Filippi – Sidironero – Thisavros dam – Thessaloniki.  Leaders: S. Dabizias, G. Koufos, G. Eleftheriadis, A. Kilias.  Price: € 185 per person.  F4: SW Thrace (18 – 19 April 2004).  Topics: The high sulfidation epithermal-type ore deposits of SW Thrace are associated with the Tertiary extensional tectonism in the area and the related magmatic activity. This field trip includes visits to the Perama, and Sappes deposits. Emphasis will be given to the geological setting and evolution of the deposits, the plans for mine development and the methods which will be applied for environmental protection of the sites. During the visit in the idle mine of Agios Filippos (Kirki) the environmental impact of past mining and ore processing will be traced and proposals for site rehabilitation will be discussed.  Route: Thessaloniki – Kavala – Xanthi – Komotini – Alexandroupolis – Thessaloniki.  Leader: N. Skarpelis.  Price: € 120 per person  F5: Lesvos island (18 – 20 April 2004).  Topics: General geology, volcanology, geothermy, geotopes (Lesvos petrified forest). A workshop taking place in the Natural History Museum of the Lesvos Petrified Forest is also included.  Route: Thessaloniki – Mytilene – Sigri – Molyvos – Thessaloniki.  Leaders: N. Zouros, M. Fytikas.  Price: € 250 per person (includes air tickets between Thessaloniki and Lesvos) Furthermore, the following general interest tours for both the delegates and their spouses have been scheduled:  T1: Byzantine Thessaloniki (16 April 2004). Afternoon sightseeing tour in English, to view some of the impressive Byzantine monuments including the city walls and citadel, 6

St. Dimitrios Church and crypt, Galerius Arch and Palace. Price: € 32 per person (includes coach, guide, and entrance fees).  T2: Land of Alexander the Great (16 or 17 April 2004). Departure 12 noon. The name of this tour conjures up vivid pictures of Macedonia’s past. Arrive at Vergina for lunch and visit to the famous Philip of Macedon’s tomb and its treasures). Return to Thessaloniki. Price: € 60 per person (includes motorcoach, guide, lunch, entrance fees).

Accommodation For hotel bookings, air travel and any other arrangements, participants should contact “Charioteer Travel” directly, the official travel agency for the Symposium. Deadline for hotel bookings is February 14, 2004 but due to the Greek Orthodox Easter (April 11, 2004) it is strongly recommended to book well in advance. Flights and other travel arrangements to and within Greece can also be arranged. Air tickets can be ordered and delivered speedily to any specified address in the world. The agency’s address is: Charioteer Travel 36, Ermou Street GR-54623 Thessaloniki, Greece Tel.: +30 (231) 02.29.230, +30 (231) 02.84.373 Fax: +30 (231) 02.28.968 e-mail: [email protected] Indicative rates of hotels are per room per night and include VAT, taxes and service (breakfast included except for 5 star hotels): Category Hotel Accommodation Single Twin / Double ««««« Deluxe accommodation, minibar, TV, safe, €220 - €270 €220 - €270 bathroom. (Hotel upon request) «««« HOTEL CAPSIS € 120 € 135 Well appointed rooms, minibar, TV, bathroom ««« HOTEL BEST WESTERN VERGINA € 80 € 90 Good standard rooms with private bath / shower «« HOTEL PELLA € 60 € 75 Standard rooms with private shower Participants interested in booking a hotel through Charioteer Travel should complete the Hotel Reservation and Field Trip & Tour Booking Form (Form B).

Dates and Deadlines  Advance registration: October 31, 2003  Extended abstract submission: November 30, 2003  Field trip registration: after January 1, 2004  Hotel reservation forms: February 14, 2004

General Information  Joint event. 5th ISEMG will be organised concurrently with the 10th International Congress of the Geological Society of Greece (http://geo.auth.gr/ege2004). Participants of both events will have the right to attend each other’s sessions, without access to printed material.  Facilities. Delegates of the 5th ISEMG may use the University of Macedonia restaurant at specially reduced prices, using coupons available from the Symposium’s secretariat. Internet access will be available at no charge. 7

 Accompanying persons. Spouses and other accompanying persons are welcome to 5th ISEMG. They may participate in tours T1 and T2 (16 and 17 April, 2004) with the same fees as the delegates.  Transportation. The University of Macedonia building, which will host the 5th ISEMG, is located in the city centre, very close to the Aristotle University. Public bus and taxi services to and from the centre of the city are provided on a 24h basis. One - way bus ticket costs € 0.45, while taxi fees depend on the time of arrival, traffic load, etc., but normally should not exceed € 15.00 for any route within the city limits.  Arrival by air: Macedonia International Airport of Thessaloniki (airport code SKG) has daily connections to all major European destinations through scheduled services of a large number of major international airlines. It is located 15 km away from the city centre with regular public bus connections. There are also some low-cost charter flights operating from European cities directly to Thessaloniki. An alternative option is to use the low-cost carriers’ flights operating to Athens and connect by train to Thessaloniki. Delegates are strongly recommended to book air travel as early as possible as Greece is a busy tourist destination.  Arrival by train: The city’s railway station is the largest in Greece, and is located very close to the city centre. There are international daily arrivals and departures from and to several destinations. It is served by a dense network of public bus transportation. Timetables and tickets are supplied by the (OSE) Hellenic State Railways Offices (Thessaloniki office tel: +30 (231) 05.17.517).  Arrival by car: Those wishing to drive to Greece may either ferry their cars across to one of the country's major ports (Igoumenitsa, Piraeus, Patra etc.) or enter the country overland. The mainland points of entry are Kakavia, Kristallopigi (Albania), Evzoni, Niki (FYR of Macedonia), Promahonas (Bulgaria), Kastania and Kipi (Turkey). All seven border stations mentioned above operate on 24 hour service basis.  Visas. Greece is a member of the European Union; therefore no visa requirements for E.U. citizens are necessary. Non - E.U. participants should contact their nearest Greek Embassy or Consulate for further information. For a complete listing of Greek Embassies and Consulates abroad, including full contact information, you can visit the page http://www.mfa.gr/english/the_ministry/missions/. Those who require a formal invitation for the purpose of obtaining a visa, or raising travel funds in their country, may apply to the Executive Secretary.  Insurance. Travel insurance and medical care, when needed, are solely under the responsibility of the participants.  Climate & Clothing. Weather is usually mild in April, but it can occasionally be wet. Temperatures may sometimes reach well above 20o C. Generally one should expect sunny days, probably with high humidity and perhaps cool nights which require warmer clothing.

Useful addresses Some Internet addresses that might be of use to the participants:  Organisation  Fifth International Symposium on Eastern Mediterranean Geology official web page: http://www.geo.auth.gr/5thISEMG.  Tenth International Conference of the Geological Society of Greece official web page: http://www.geo.auth.gr/ege2004.  Department of Geology, Aristotle University of Thessaloniki (organising institute): http://www.geo.auth.gr.  University of Macedonia (hosting institute): http://www.uom.gr.  Travel  Charioteer Travel, official travel agency of the 5ISEMG: [email protected]

 List of Greek Embassies and Consulates, including information on visa requirements and full contact details: http://www.mfa.gr/english/the_ministry/missions.  Thessaloniki international airport, general information: http://www.hcaa-eleng.gr/thes.  Public bus schedules, routes and maps: http://www.oasth.gr (in Greek).

REGISTRATION AND REMITTANCE FORM Please fill this form in capital letters and forward it by postal mail or fax to: A Dr. Panagiotis Tsourlos, 5th ISEMG Treasurer, School of Geology, A Aristotle University of Thessaloniki, GR – 54124, Thessaloniki, GREECE. Fax: +30 (231) 09.98.528 Title (Prof., Dr., Mr., Mrs., Miss) Sex (M/F) Reference number*

First name Middle name(s)

Last name

Department

Institute / University / Company

Address

City / Town Postal code / ZIP

Country

Telephone Facsimile

e-mail

* to be completed by the Organising Committee.

REGISTRATION FEES (please tick the appropriate box) Before October 31, November 1, 2003 – Category 2003 January 31, 2004 After February 1, 2004 Professional  € 110  € 130  € 150 Student*  € 90  € 90  € 90 * Current student ID is required to take advantage of the student rates. A photocopy of the ID should be included with this form. METHOD OF PAYMENT IN EUROS (please tick the appropriate box) □ Bank transfer to the order of Account No. 5202-002154-676, Piraeus Bank S.A., Aggelaki, Thessaloniki Branch (2202), 18 Aggelaki St., 54621, Thessaloniki, Greece. SWIFT code: PIRBGRAA, IBAN: GR2501722020005202002154676. In this case, a copy of the transaction should be sent by mail, fax, or e-mail to the Symposium Treasurer: Dr. Panagiotis Tsourlos (5thISEMG), School of Geology, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece. Fax: +30 (231) 09.98.528. e-mail: [email protected]. □ Bank cheque made payable to Dr. Panagiotis Tsourlos (Treasurer) and mailed to the above mentioned address (personal cheques are not accepted). □ Credit Card □ Visa □ MasterCard Name of card holder:...... Card No:...... Expiry date:...... I hereby authorise the Organising Committee to charge my above credit card with the registration fees noted on this form. Date: ...... Signature:......

HOTEL RESERVATION AND FIELD TRIP & TOUR BOOKING FORM Please forward this form either by mail, fax or e-mail attachment to: CHARIOTEER TRAVEL, 36 Ermou Str, GR-54623 Thessaloniki, Greece B Tel.+30 2310 229230, +30 2310 284373, Fax +30 2310 228968 B e-mail: [email protected]

FAMILY NAME:...... NAME(S):...... POSTAL ADDRESS:...... CITY:...... ZIP CODE:...... COUNTRY:...... TEL: ...... FAX: ...... E-mail:...... ACCOMPANYING PERSON(S): ......

HOTEL RESERVATION REQUEST Category Hotel Accommodation Single Twin / Double ««««« Deluxe accommodation, minibar, TV, safe, bathroom. €220 - €270 €220 - €270 (Hotel upon request) «««« HOTEL CAPSIS € 120 € 135 Well appointed rooms, minibar, TV, bathroom ««« HOTEL BEST WESTERN VERGINA € 80 € 90 Good standard rooms with private bath / shower «« HOTEL PELLA € 60 € 75 Standard rooms with private shower Name of Hotel:...... Arrival date:...... Departure date:...... No. of Single rooms ...... x €...... x ...... nights = €...... No. of Twin rooms ...... x €...... x ...... nights = €...... FIELD TRIP BOOKING REQUEST (minimum participation: 15 persons) Description Date No. of persons Price Total F1 Mygdonia basin and eastern Chalkidiki 14 April € 30 € F2 Western Macedonia 18-19 April € 120 € F3 Eastern Macedonia – Thrace 18-20 April € 185 € F4 SW Thrace 18-19 April € 120 € F5 Lesvos island 18-20 April € 250 € F6 Southern Bulgaria 18-20 April € € TOUR BOOKING REQUEST (minimum participation: 15 persons)

Description No. of persons Price Total T1 Byzantine Thessaloniki (16 April) € 32 € T2 Land of Alexander the Great (16 or 17 April) € 60 €

Total payment € ......

Method of payment in Euros (please indicate by ticking appropriate box): □ Bank transfer to the order of Charioteer Travel Account No. 474 00 2002002793, Branch Code 747. Swift Code CRBAGRAAXXX, ALPHA BANK, 55 Ermou Street, □ Bank cheque made payable to Charioteer Travel and mailed to the agency’s office address: 36 Ermou Str, GR-54623 Thessaloniki, Greece (personal cheques are not accepted). □ Credit Card □ Visa □ Mastercard □ American Express □ Diners Club Name of card holder:...... Card No:...... Expiry date:......

I hereby authorise CHARIOTEER TRAVEL to charge my above credit card with the total payment of services noted on this form.

Date: ...... Signature:...... 11

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