GLOW IV Registration Form

GLOW IV Symposium:
State of Lake Tanganyika, a Case Study

REGISTRATION FORM

Name:________________________________________________________________________________________

Institution/Agency:_____________________________________________________________________________

Address:______________________________________________________________________________________

Postal/Zip Code:__________________________________________

Country:______________________________________________________________________________________

Telephone (& Country code):_______________________________________Fax:_______________________________

Email:__________________________________________________

AEHMS MEMBERS : [ ] $60.00 USD – Africans [ ] $250.00 USD – Non-Africans

NON-MEMBERS : [ ] $100.00 USD – Africans [ ] $300.00 USD – Non-Africans

Registration after January 10^th, 2006 will include a late fee of $25.00 for Africans and $50 for Non-Africans.

TOTAL: $_______________.00 USD

METHOD OF PAYMENT:

A. Credit Card: MasterCard: [ ] Visa: [ ]

Card Number: _______________________________________ Expiry Date: ___________________________

Signature: _______________________________________________Date:______________________________

B. Cheque: Bank draft/money order in U.S. funds payable to "Aquatic Ecosystem Health and Management Society"

Signature:_________________________________________________Date:____________________________

Return to:

AEHMS, P. O. Box 85388, Brant Plaza Postal Outlet, Burlington, Ontario, Canada, L7R 4K5.

E-mail: lorimerj@dfo-mpo.gc.ca Fax: +1 (905) 634-3516 Visit our website: www.aehms.org

ACCOMMODATION INFORMATION:

The Symposium will be held at the Oceanic Bay Hotel in Bagamoyo, Tanzania (www.oceanicbay.com). Please contact the hotel to make your booking at info@oceanicbay.com. Identify your email with "GLOW4" written in the subject line. Rates are given below in USD:

Room	Board	Rate
Single	Breakfast	$65.00/night
	Bkfast & Lunch	$75.00/night
	Bkfast, Lunch & Dinner	$85.00/night
Double	Breakfast	$100.00/night
	Bkfast & Lunch	$126.00/night
	Bkfast, Lunch & Dinner	$152.00/night

SHUTTLE INFO:

Shuttles will be leaving for the hotel from Dar es Salaam International Airport three times on Sunday, February 19th, 2006: 09:00, 14:00, 23:00, and once on Monday morning at 07:30. A return shuttle will be organized for after the symposium. Shuttle rides will cost $25.00 USD. Payment can be made at the registration desk.