Untitled Document

Registration Form

Fifth International Conference on New Theories, Discoveries and Applications of Superconductors and Related Materials
(New3SC-5)

June 11-16, 2004
Hilton-Chongqing (Chungking), China

(www.jddis.org or www.phys.subr.edu/conference/newSite/index.htm )

Please type or print:

Family Name First Name Middle Initial

Institution/Company	Mailing Address (Street, City, State/Province, Zip/Post Code, Country)

E-Mail
Phone Fax
(Students only) Please indicate your advisor's name and institution:

Please check or fill appropriate blanks:
* This is my preliminary registration. I may formally register afterwards.
* I have decided to participate in the conference, A check including

Fees for the Registration package I ,II , III ,	$	or RMB
Additional Proceedings ($50/vol)	$	or RMB
Companion Program ($120)	$	or RMB
Companion at Banquet ($20/person)	$	or RMB
Banking charge for wiring ($20)	$	or RMB
A total of	$	or RMB

is enclosed or being wired.
* Alternatively, please charge this to my credit card:
VISA , MasterCard , Discover .

Card Number:		Expiration Date:
Signature:		Date:

Or Mail your registration form to:

Out of the Mainland of China	OR	On the Mainland of China
Secretariat of New3SC-5 14027 Perkins Road, Suite 1 Baton Rouge, LA 70810, USA Phone: +225.769.5193 Fax: +225 771-3926	OR	Secretariat of New3SC-5 Room 210, College of Mathematics & Physics Chongqing University, Chongqing 400044, China Phone:+ (023) 66668-9968 Fax: + 9023) 6511-1960

Wire to: Bank One Louisiana, P.O. Box 1231, Baton Rouge, LA 70821, USA
Routing Number: 065400137, Account Number: 79005 40978, Check cashable in US must be payable to New3SC

Correspondence Addresses:

Secretariat of New3SC-5
14027 Perkins Rd, Suite A.
Baton Rouge, LA 70810, USA

Email Address:

new3sc@phys.subr.edu