Please print this page, and fill in the relevent information. The completed registration form should be faxed to the McGill Physics Department at +1 514 398-8434. If a cover sheet is included, please specify "HE06 Meeting" as the recipient. A fee of Cdn$100 will be charged for registration with payment prior to June 4. Registration with payment after this date will cost Cdn$130. Current exchange: Cdn$1=US$0.88=EU0.71, Apr 15. Graduate students registered before the June 4 early deadline are entitiled to a special registration fee of $50.

Alternatively, payment of Cdn$130 can be made on arrival in Montreal either by credit card or in Canadian currency.

Full name (as it appears on card):                                            

Card Type (circle one):         American Express         Visa           Mastercard

Card number:                                   

Expiration date                      

Payment amount (circle one registration and conference dinner):
Early Registration: Cdn $100 (before June 4)
Early Graduate Student Registration: Cdn $50 (before June 4)
Registration: Cdn $130 (after June 4)   
Conference Dinner: Cdn $60

Signature                                        

Phone/fax number