PROGRAMME OUTLINE	PROVISIONAL SCHEDULE	REGISTRATION
OPTIONAL EXCURSIONS	HOTELS	METHOD OF PAYMENT

Registration fees include the Symposium gala dinner, are as follows:

Post July 1 2000 Registration  US$ 200     Post July Registration Fee                        ...............................
Accompanying Person             US$ 125     Accompanying Registration Fee               ...............................

                                                                  Total Basic Registration                           ...............................

FIRST NAME AND FAMILY NAME  ............................................................................................
POSTAL ADDRESS  ..................................................................................................................
...............................................................................................................................................
POST CODE/ZIP................................................COUNTRY..........................................................
TEL.................................................................FAX .................................................................
E-MAIL ...................................................................................................................................
ACCOMPANYING PERSON'S FIRST NAME AND FAMILY NAME
...............................................................................................................................................

*  Reservations and payment for Tour 5 must be received by 1st October.
**  Tour 5 lunch: select one per person from:   chicken breast  /  seasonal fish  /  roast beef au jus
 

Excursion	Description	Price  per person  US$	No. of Persons  =  Total $
Tuesday 16th October
Tour 6	Post-conference tour of University of Wisconsin-Madison and Southwestern Wisconsin	$145 per person double occupancy # $199 per person single occupancy	=  $

#  To receive the double occupancy rate, identify the person you intend to stay with

Total due basic registration $ ............plus excursions $ .............  =  Grand Total $ ..................

All payment should be made by credit card (Visa, Mastercard or American Express) or cheque payable in US Dollars to "IMCoS 2001"
 

Credit card no.....................................................................Visa/Mastercard/American Express
Name on card ...............................................................................Expiry date ...................................

I hereby authorise the payment of US$:...........................................Date...............................................

Mail this registration form and payment to:

         IMCoS 2001
         Hermon Dunlap Smith Center for the History of Cartography
         The Newberry Library, 60 W. Walton Street, Chicago, IL 60610-3380, USA
         Tel:  +1 312 255 3659     Fax:  +1 312 255 3502     E-mail:  smithctr@newberry.org