REGISTRATION FORM Sample s2

Registration Form International Conference on Mountains and Climate change: Resources, Challenges and Opportunities for Better Life and Livelihoods September 17 – 19, 2015

Integrated Mountain Areas Research Centre (IMARC) Karakoram International University, Gilgit, Pakistan

Program and lodging information: www.kiu.edu.pk/conference Full Name: ______(First name for badge)______University/Organization: ______Preferred Mailing Address:______City: ______State/Province: ______Zip/Postal Code: ______Country: ______Telephone: (______)______Fax: (______)______Email: ______

REGISTRATION DETAILS

Please check the relevant  I would like to participate in the oral presentation Title of Talk: ______Brief Abstract (max 300 words, please attach to form):

 I would like to attend the conference, but not present.

 I would like to participate in the poster presentation session. Poster Title: ______Names of other contributors (if group): ______

______

 I would like to participate the post-conference visit

CONFERENCE FEES

Registration Fees: Please check the relevant. The registration fee covers meals during conference, abstract booklet and stationary.

PLEASE CHECK APPROPRIATE REGISTRAION FEE: EARLY REGISTRATIONON-SITE REGISTRATION Pakistani National (Students)  Rs. 1000  Rs. 1500 Pakistani National (Professionals)  Rs. 5000  Rs. 7000 SAARC Countries  USD 100  USD 150 All other nationals  USD 200  USD 250

Cancellations/Changes and Refunds: Registration fees will be refunded if cancellation is received in writing no later than September 4, 2015. After that date, registration fees are non-refundable. All refunds will be processed after the conference.

Payment method: Please state the conference name and the full name of the participant. The conference fee should be paid by cheque or electronic transfer to this account:

Account title: KIU – Recurring Grant Account Number: 01077900246701 Bank: Habib Bank Limited Main Branch Gilgit

Payment should be made in Pakistani Rupees

Date: ______/______/______Signature:______

Please mail or fax completed registration form with payment details to:

Mr. Muhammad Zafar Khan Phone: 0092 5811 960011-12 Ext: 166 Assistant Professor FAX: 0092 5811 960045 Department of Environmental Sciences Emai: [email protected] Karakoram International University, University Road, Gilgit-15100, Pakistan