<p>VI International Congress for Mining, Oil, and Energy Cartagena de Indias, Colombia – 12, 13 and 14 OF MAY, 2010</p><p>REGISTRATION FORM</p><p>LAST</p><p>NAME: </p><p>FIRST</p><p>NAME:</p><p>IDENTIFICATION: </p><p>COMPANY OR</p><p>ENTITY:</p><p>NIT: </p><p>ADDRESS:</p><p>CITY: </p><p>COUNTRY:</p><p>E- MAIL: </p><p>TELEPHONE: FAX:</p><p>MOBILE: </p><p>NAME OF GUEST (S):</p><p>COST OF REGISTRATION</p><p>Col $850.000 + 16% VAT Until April 12th, 2010 US$ and € Col $ 900.000 + 16% VAT According to Exchange rate on From April 12th, 2010 day of registration</p><p>HOTEL RESERVATION Please complete a request form for each participant. </p><p>HILTON HOTEL CARTAGENA (5 STARS)</p><p>KIND OF ROOM ROOM RATES VI International Congress for Mining, Oil, and Energy Cartagena de Indias, Colombia – 12, 13 and 14 OF MAY, 2010</p><p>Central Building Single Col $402,000 + 10% VAT Double Col $457,000 + 10% VAT</p><p>DATE OF ARRIVAL:</p><p>DATE OF DEPARTURE: The above rates are per room and per night, and include a buffet breakfast. The tourism tax is not included and has a cost of approximately Col $3,114 per room, per night. Once completed, the hotel reservation can be secured with a credit card payment of the first night of your stay. </p><p>FORMA DE PAGO – COL $ VI International Congress for Mining, Oil, and Energy Cartagena de Indias, Colombia – 12, 13 and 14 OF MAY, 2010</p><p>REGISTRATION $ HOTEL $ TICKET $ TOTAL AMOUNT DUE $ BANK DEPOSIT OR TRANSFER Payment can be made at the following national bank accounts: Account Name GEMA TOURS S.A GEMA TOURS S.A Bank Name BANCO DE CREDITO DAVIVIENDA Account Number 501350037 7020154595 Send a copy of the deposit or transfer slip to the following fax number (57 1) 212 6146 or email address [email protected] CREDIT CARD PAYMENT (Please fill out authorization details) Card Number Expiration Date Visa: American Express: Master Card:</p><p>I authorize that the amount above be charged to my credit card: </p><p>PAYMENT METHOD – US$ or € REGISTRATION $ HOTEL $ TICKET $ TOTAL AMOUNT DUE $ DEPOSIT OR BANK TRANSFER</p><p>BANCO DE CREDITO Checking Account Name Gema Tours S.A. Account No. 501 35003 7, Business Collection Code 9037</p><p>BANCO DAVIVIENDA Checking Account Name Gema Tours S.A. Account No. 7020154595 Payment can be made to the following international bank account: Account Name GEMA TOURS S.A Bank Name HELM BANK ABA Code 0670111456 Account Number 1040095207 Bank Address 999 Brickell Avenue, Miami, Florida, 33131, USA Note: Please send a copy of the transfer to the following fax number (57-1) 212 6146. All additional bank charges are the responsibilty of the participant.</p><p>FLIGHT RESERVATIONS</p><p>Please fill in the following information to receive special airfare rates: VI International Congress for Mining, Oil, and Energy Cartagena de Indias, Colombia – 12, 13 and 14 OF MAY, 2010</p><p>Route: Date of Arrival: Preferred Time:</p><p>Route: Date of Arrival: Preferred Time:</p><p>GEMA TOURS S.A. CONTACT DETAILS FOR INFORMATION AND REGISTRATIONS Gema Tours S.A. (Bogotá) 346 50 25 Diana Velasquez [email protected] </p><p>Gema Tours S.A. (Cartagena) 660 24 99 Sugey Pajaro [email protected] </p>