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

Three Ways to Register
Register On-Line
Http://conferences.ucdavis.edu
(Click on Academic)
Credit Card Payments Only
Register by FAX
Complete this form and FAX to (530) 752-5791
Credit Card Payments Only
Register by Mail
Mail completed form and payment to:
Conference & Event Services
University of California
One Shields Avenue
442 Memorial Union
Attn: Grapevine
Davis, CA 95616
Cancellation Policy
All cancellation must be received in writing no later than Friday, June 4, 2004. Cancellations received after Friday, June 4, 2004 will not be processed. Cancellations received prior to this date and time are usually processed after the conclusion of the conference and will be refunded minus a $40 administrative processing fee.
Mail Cancellations to:
Conference & Event Services
University of California
One Shields Avenue
442 Memorial Union
Attn: Grapevine
Davis, CA 95616 / Registrant Information
A separate form is required for each registrant. (Please print legibly or type)
Name:
Last / First / MI
Affiliation:
Address:
Street Address
City / State / Zip Code / Country
Phone: / () / Fax: / ()
Please include area, city and country codes / Please include area, city and country codes
Email:
Required for confirmation purposes
Registration Fees
Registration forms must be received by June 11, 2004
After this date, registration will need to take place on-site at the higher registration fee

Registration Fee Per Person

/ By May 14th / As of May 15th /

Totals

ISHS Member / $360 / $410 / $
Non- ISHS Member / $385 / $435 / $
Student Registration[1] (Fax Proof to 530-752-5791) / $200 / $225 / $
Banquet (6/24/04) / $30 x ______/ $
Total / $

Companion/Guest ToursLast day to register for tours is Jun 4, 2004.

San Francisco Bay Cruise (6/25/04) / CLOSED DUE TO LOW ENROLLMENT
Name of paid guest: /
Lake Tahoe Tour (6/22/04) / CLOSED DUE TO LOW ENROLLMENT
/ Name of paid guest: / /

Total

/

$

/

Tours may be cancelled due to low enrollment. If tour is cancelled, payment will be refunded.

Conference Questions

Do you have any special dietary needs? (ex: food allergies, vegetarian, vegan, etc) / Yes / No
Please Explain:

Payment Information

Enclosed is my check/money order made payable to "UC Regents"
UC Davis DAFiS or UC Campus Recharge (please include Acct , Sub Acct, Dept, Acct Manger and Phone)
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 to inquire on whether your registration form was received

[1] Proof of full-time student status required