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\def\koutaki{$\Box$}
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\begin{document}
\vspace*{-1cm}
\begin{center}
{\bf Joint European and National Astronomical Meeting for 1997\\
{\Large \bf JENAM - 97}\\
2 -- 5 July 1997}

{\Large \bf P A Y M E N T \ \ F O R M}
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\vspace{0.1cm}
\hrule
\begin{center}
\begin{tabular}{p{11cm}}
Submit this form by normal post or fax to the {\bf Contact address}
of the Local Organising Committee, mentioned in \S 3.\\
\multicolumn{1}{c}{\bf Deadline for early registration: March 15, 1997}\\[0.1cm]
\multicolumn{1}{c}{Direct questions to: {\bf elaset@astro.auth.gr}}
\end{tabular}
\end{center}
\hrule
\vspace*{0.5cm}
Family Name:\ \hrulefill\ First name:\ \hrulefill\ Institution:\ \hrulefill
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\begin{tabular}{|c|p{4cm}p{4cm}|}
\hline
\multicolumn{3}{|c|}{\bf Payment Information}\\
\hline
 & & \\[-0.3cm]
Registration      & US\$ : & GDr: \\
Hotel Reservation & US\$ : & GDr: \\
 & & \\[-0.3cm]
\hline
Total amount & US\$ & GDr \\
\hline
\end{tabular}
\end{center}

\underline{\bf Method of Payment}

At the moment we are unable to accept {\it Credit Card} payments. Most
favoured method is by {\it Money Transfer} to the account mentioned below.
In this case please send us the details of the {\it Transfer Transaction}
(name of remitter, date of transaction and Bank name). If you pay by cheque, 
please add an extra GDr 2000 (US\$ 8) which represents the bank charges.
All foreign payments must be in US\$.\\
\begin{tabular}{lp{12cm}}
%\begin{tabular}{ll}
\koutaki \ By Cheque & (Payable to the order of {\it H. Varvoglis, JENAM-97})\\
\koutaki \ By Money Transfer & 
(Amount tranferred\ \hrulefill\ Name of remitter\ \hrulefill\\
 & Date\ \hrulefill\ through \hrulefill\ (Name of Bank)\\
 & to the Conference account (Ref. {\it JENAM-97}
   at the ``Bank of Macedonia-Thrace, Aggelaki Str. 18, GR-54621 
   Thessaloniki, Greece, account number {\bf 602-00-111-0152413-0}.
   Please indicate clearly your name, country and the key-word 
     ``{\it JENAM-97}"))
\end{tabular}

\underline{\bf Cancellation}\\
In the event of cancellation, written notification should be sent to the LOC.
The following {\it cancellation fees} will be deducted before refunding.\\
{\sc Registration:}  {\it Up to June 27, 1997}: the Bank charges, which could be between 0 and 4000 drachmas (US\$ 16 -- depending on the  method of payment). 
{\it After June 27, 1997}: 50\% of the registration fees (minimum: the Bank charges).\\
{\sc Hotel reservation:}  {\it Up to April 10, 1997}: the Bank charges. 
 {\it After April 10, 1997}: The hotel deposit + the Bank charges. 

As mentioned earlier, the LOC is working hard towards obtaining
local support for the Conference.  However, at the moment the outlook
is not very encouraging. Please indicate below if your attendance will
be conditional on receiving financial support.

\underline{\bf Comments:}

\hspace*{9.7cm} Signature: . . . . . . . . . . . . . . . . \\

\fbox{
\centerline{\large \rm PLEASE RETURN ASAP. Do not wait for the deadline
           of March 15, 1997}
}

\end{document}

