Arab Organizers

R e g i s t r a t i o n F o r m

Please select the name of the conference

Registration

Title

Family Name

First Name

Name on Badge

Institution/ Company

Address

Division / Department

City

Postal Code

State / Province

Country

Phone

Fax

E mail

I will present Paper

Yes

Accompanying Persons

Title

Family Name

First Name

Title

Family Name

First Name

Registration Fees

	Member
	Non Member
	Non Jordanian Member
	Residents
	Accompanying Persons - Intern Students and nurses (For Scientific Program only)

Hotel Registration

Arrival Date			Carrier / Flight No.			Time
Departure Date			Carrier / Flight No.			Time

Please Tick	Hotels	Rating
	Marriott -Dead sea	5*
	Movenpick -Dead sea	5*
	Le Meredien	5*
	Le Royal	5*
	Inter Continental	5*
	Grand Hyatt	5*
	Holiday Inn	4*
	Marmara	3*
	Al-Qaser	3*

* All above rates are inclusive ( Tax. Service and Breakfast )

Congress Tours

Tours	Date	No. of Persons
T1
T2
T3
T4
T5

Airport Transfer

Meet and Assist at the airport and transfer to hotel.

Airport to Hotel (20$)

Hotel to Airport (20$)

Date

Pick up time

Drop off time

- Payment should be paid in US Dollars either by telegraphic transfer or by Bank Draft in favor of the Arab
Organizers Co.
- Credit Cards and personal cheque are not accepted.