* Upon presentation of student identification  

Fees for Participants include:
	Attendance at the Symposium Scientific Program
	Symposium kit (including program, writing utensils and name tag)
	Lunches and Refreshments
	Social Events as per Social Program (excluding optional event)

Fees for Accompanying Persons include:
	Social events as per Social Program (excluding optional event)
	Lunches

Registration Fees Cancellation Policy
Refund of registration fees will be made as follows (less US $80 handling fee):

	Notification received by fax/e-mail before July 10, 2000	full refund
	Notification received by fax/e-mail after  July 11, 2000	50% refund
	Notification received by fax/e-mail after August 10, 2000	no refund

Preliminary Registration
Please complete the enclosed registration form and send it together with your payment to the Symposium Secretariat. Payments can be made by bank draft or bank transfer to Account #142-47233,Bank Hapoalim, Branch 554,Namir Square, Tel Aviv, by Eurocheque (in the currency of the issuing country), by Travelers Cheques or by credit cards (Visa/Mastercard/Diners/American Express only). 

THE 6th SYMPOSIUM ON: COMPUTERS IN DIABETES Herzlia, Israel, September 14-16, 2000 REGISTRATION FORM Title: Prof.  Dr.   Mr.   Mrs.    Ms. Surname:   First Name: Affiliation: Address: City: Country:   Zip/Code: Tel:   Fax: E-Mail: Accompanying Persons Family Name: First Name: Family Name: First Name: Registration Fees Fees in US $ Until June 30, 2000 After June 30, 2000 Participant US$ 210 US$ 240 Student * US$ 100 US$ 130 Accompanying Person US$ 100 US$ 110 Tel Aviv - Jaffa Night Tour and Dinner US$  35 US$  35 * Upon presentation of student identification   Attached is payment in the amount of US $ made out to Ortra Ltd. by: Credit Card: Credit Card: Select Card Type MasterCard/EuroCard Visa American Express Diners   Expiry Date: MM 01 02 03 04 05 06 07 08 09 10 11 12 YYYY 1999 2000 2001 2002 2003 Card No. Card Holder Eurocheque: Eurocheque # (In the currency of the issuing country). Bank transfer: I am sending a bank transfer to account #142-47233, Bank Hapoalim, Branch 554, Namir Squre, Tel Aviv. Copy of bank transfer Document enclosed. Bank draft: Bank draft # Special Requests: