Participation is by invitation only. If you have been invited,
please cut the registration form below, fill it and send it 
at your earliest convenience to:

	now2004@ba.infn.it
	by e-mail (preferred)

	or by fax to:
	Mr. Antonio Silvestri
	NOW 2004 Secretariat
	INFN, Bari
	fax ++39 080 5534938

                 DEADLINE FOR REGISTRATION: AUGUST 7, 2004

IMPORTANT NOTES:

We strongly recommend participation for the whole Workshop period, i.e.,
arrival on Sept. 11 (Saturday) and departure on Sept. 18 (Saturday).
Accommodation at Hotel Daniela CANNOT be extended beyond these dates.
Hotel Rate (Full board): 
Double room: 63 Euro/night/person;
Double room for single use: 78 Euro/night. 

Conference Fee = 250 Euro (To be payed cash at arrival). 
No conference fee for accompanying persons. 

___________________________ cut here _________________________________________


      REGISTRATION FORM : NEUTRINO OSCILLATION WORKSHOP 2004 (NOW 2004)

(*) = Required fields

	PERSONAL DATA:

First name (*) ...............................................................
Middle name ..................................................................
Family name (*) ..............................................................
Sex (*) ......................................................................
Age ..........................................................................
Professional status ..........................................................
Field of interest ............................................................
Institution (*) ..............................................................
..............................................................................
Address (*) ..................................................................
..............................................................................
..............................................................................
Fax (*) ......................................................................
Phone ........................................................................
E-mail (*) ...................................................................


	TRAVEL AND ACCOMMODATION:

Expected Arrival date (*) ....................................................
Expected Departure date (*) ..................................................
By (check one): Plane / Train / Car (*) ......................................
Will you use the Workshop shuttle (*) ........................................
Will you be accompanied (*) ..................................................
By your spouse : First and Family name .......................................
By your children : First Name ..................................... Age ......
                   First Name ..................................... Age ......
                   First Name ..................................... Age ......
Do you wish to have a single room (*) ........................................
If you wish to share a double room, please specify:  Smoker ... Non-smoker ...


Date (*) ...................... Signature ....................................