To ensure participation in the CIB/APARG Conference and the JRT Interim Meeting, please send the information requested on this application form to the JRT convenors by e-mail before 1 November to:

Deepak at deepak_ajwani@timesgroup.com, Dorien at dorien.moret@planet.nl, or Hein at hein.bogaard@tiscali.nl

We will forward your information to the conference organisers and make sure that you receive confirmation of your registration. Confirmation implies that a room will be reserved for you and that you are expected to pay for it.

Personal information

Name:

Age:

Street Address:

City, State and Postal Code:

Country:

Phone:

Fax:

E-mail:

Company:

Job title:

Education:

Previous work experience:

Do you want to participate in the optional JRT Programme (January 9, 12 and 13 – additional cost USD 100)?

Yes [ ] or No [ ]

Arrival date and time:

Departure date and time: