FORM A

The 4th International Yellow River Forum (IYRF)

On Ecological Civilization and River Ethics

Oct. 20-23, 2009, Zhengzhou, China

Please complete and return this FORM not later than June 30, 2009. to:

Mr. Shang Hongqi

Secretary General, LOC of IYRF

Department of International Cooperation, Science and Technology

Yellow River Conservancy Commission

11 Jinshui Road, Zhengzhou 450003, China

Tel: +86-371-66025954 Fax: +86-371-66024477

Email: or

Please type or print, do not write illegibly.

REGISTRATION

PARTICIPANT DATA
Contact Details
Name / First Name Family/Last Name
Title (Prof / Dr. etc) / Gender / □ Male □ Female
Organization
Department / Position
Postal Address
Postcode / City/Suburb
State / Country
Phone / Country Code Area Code Phone Number
+
Fax / +
Email
Visa Application
Name in passport
Passport Number / Nationality
I will apply visa in (City, Country)
ACCOMPANY PERSON DATA
Contact Details
Title (Prof / Dr. etc)
Name / First Name Family/Last Name
Visa Application
Name in passport
Passport Number / Nationality
I will apply visa in (City, Country)

All the payment listed below is in US Dollar.

A. REGISTRATION FEE(tick the selected)
Before August 20, 2009 / After August 20, 2009 / Total
Regular participants, tick the selected / □$500 / □$600
Accompanying person, tick the selected / □$300 / □$400
Daily registration, tick the day / $200per day □TUE □WED □THU □FRI
Total registration fee / USD

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FORM B

The 4th International Yellow River Forum (IYRF)

On Ecological Civilization and River Ethics

Oct. 20-23, 2009, Zhengzhou, China

Please complete and return this FORM not later than June 30, 2009. to:

Mr. Shang Hongqi

Secretary General, LOC of IYRF

Department of International Cooperation, Science and Technology

Yellow River Conservancy Commission

11 Jinshui Road, Zhengzhou 450003, China

Tel: +86-371-66025954 Fax: +86-371-66024477

Email: or

Please type or print, do not write illegibly.

Personal Data
Name / First Name Family/Last Name

ACCOMMODATION

All the payment listed below is in US Dollar.

B. HOTEL RESERVATION (tick the selected)
Hotel / Star / Single / Double / Deposit requested
Yingbin Hotel of the Yellow River Henan / ★★★★ / □($55/ night) / □($60/ night) / □$60
Express by Holiday Inn / ★★★★ / □($60/ night) / □($70/ night) / □$60
Xingya Jianguo Hotel / ★★★★★ / □($95/ night) / □($100/ night) / □$60
Sofitel Hotel / ★★★★★ / □($120/ night) / □($125/ night) / □$60
Check-in date check-out date
An accommodation deposit must be paid in advance to secure your reservation.
The amount will be deducted from the total cost of your accommodation bill.
Accommodation deposit / USD
TOTAL AMOUNT DUE (A-registration +B-accommodation deposit) / USD

PAYMENT OPTIONS

1. Bank Deposit

I have remitted/will remit the above total fees on (date) payable in US Dollar (copy enclosed) to the following bank account: Beneficiary’s Bank:SWIFT: CIBKCNBJ450, CHINA CITIC BANK, ZHENGZHOU BRANCH; Beneficiary’s Name:Press and Publication Center, YRCC; Account Number:7391011482600002051.

2. Credit Card

I prefer to pay the above total fees by: (amount to be paid by credit card should be increased by 3%～5% for bank charge)

Card Type: □Visa Card □Master Card □American Express Card

Card Number Expiry Date

Cardholder Name Cardholder’s Signature

NOTE: ◆Confirmation of the registration can only be issued after receiving of the correct payments.

◆Payments will be required at the forum if your advanced payments have not been received prior to participants’ arrival.

◆For cancellations issue, see the Bulletin 2.

Signature Date (d/m/y)

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