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\noindent
Please return to: \phantom{A}
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{\em QMath7 \\ Nuclear Physics Institute, Academy of Sciences \\ 
CZ--25068 \v{R}e\v{z} near Prague, Czech Republic}
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\noindent
For my participation in the conference {\em Mathematical Results
in Quantum Mechanics} (Prague, June 22-26, 1998) I pay the
following fees: 
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\noindent
\begin{minipage}[t]{1.8in} 
Early registration \\ (till March 31)\\
Late registration \\ (from April 1)
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$\Box$\quad USD 180 \\ \\
$\Box$\quad USD 220
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$\Box$\quad DEM 320 \\ \\
$\Box$\quad DEM 390
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$\Box$\quad CHF 260 \\ \\
$\Box$\quad CHF 320
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\noindent
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A companion \\
{\em with a boat trip}
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$\Box$\quad USD 30\phantom{0} \\
$\Box$\quad USD 45\phantom{0}
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$\Box$\quad DEM 55\phantom{0} \\
$\Box$\quad DEM 80\phantom{0}
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$\Box$\quad CHF 45\phantom{0} \\
$\Box$\quad CHF 65\phantom{0}
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\noindent
Number of accompanying persons: ..........
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\noindent
\begin{minipage}[t]{1.8in} 
Board and \\ lodging (single)
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$\Box$\quad USD 265
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$\Box$\quad DEM 470
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$\Box$\quad CHF 380
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\noindent
\begin{minipage}[t]{1.8in} 
Board and \\ lodging (shared)
\end{minipage}
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\begin{minipage}[t]{1.1in}
$\Box$\quad USD 195
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\begin{minipage}[t]{1.1in}
$\Box$\quad DEM 350
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$\Box$\quad CHF 275
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\noindent
\begin{minipage}[t]{1.8in} 
Board and \\ lodging (couple)
\end{minipage}
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\begin{minipage}[t]{1.1in}
$\Box$\quad USD 390
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$\Box$\quad DEM 695
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$\Box$\quad CHF 545
\end{minipage}
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\noindent
{\em If you come with more than one person, please, contact 
the organizers to arrange the price}
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\noindent
\begin{minipage}[t]{1.8in} 
Total payment
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\begin{minipage}[t]{1.1in}
USD ..........
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\begin{minipage}[t]{1.1in}
DEM ..........
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CHF ..........
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\noindent
{\bf Modes of payment:}
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\noindent
$\Box$ \quad in cash at arrival
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\noindent
$\Box$ \quad by bank transfer in USD: to the account No.
01--351980{\bf 30}/0300: \\
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\begin{minipage}[t]{5in}
Nuclear Physics Institute, ASCR \\
Czechoslovak Trade Bank (\v{C}eskoslovensk\'{a} obchodn\'{\i}
banka) \\ Na po\v{r}\'{\i}\v{c}\'{\i} 24, 11520 Prague 1 \\ {\em
variable symbol \bf 3050}
\end{minipage}
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\noindent
{\em Please do not forget to include the variable symbol, otherwise
it may be \\ difficult to identify your payment}
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\noindent
$\Box$ \quad  by bank transfer in DEM to the
account No. 01--351980{\bf 40}/0300 at same bank and with the same
variable symbol as above
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\noindent
$\Box$ \quad  by bank transfer in CHF to the
account No. 01--10932070/0300 at same bank and with the same
variable symbol as above
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\noindent
I enclose payment of USD ........./ DEM ......../ CHF ......... by
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\noindent
$\Box$ \quad a cheque payable to the Nuclear Physics Institute, ASCR
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\noindent
$\Box$ \quad a credit card --- please use the enclosed mail order form
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\section*{Social events}

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Tuesday June 23 
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For accompanying persons: {\bf a boat trip (9am--5pm)}
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{\em Number of attending:} ........
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Tuesday June 23 evening
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{\bf Dole\v{z}al Quartet --- Concert of Czech Chamber Music}
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{\em Number of attending:} ........
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Wednesday June 24 afternoon
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{\bf Prague Sightseeing}
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{\em Number of attending:} ........
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Thursday June 25 evening
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{\bf Conference Diner}
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{\em Number of attending:} ........
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\newpage 

\begin{center}
{\large\bf Mail Order}
\end{center}
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\noindent
I wish to pay the expenses of my participation in the conference
\\ ``Mathematical Results in Quantum Mechanics" by my credit card.
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\noindent
Name: ....................................................
\quad Title: ......................................
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\noindent
Address: ......................................................................................................
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\noindent
\phantom{Address:} ......................................................................................................
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\noindent
{\bf Credit card:}
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\noindent
$\Box$ $\,$ VISA$\:$ $\Box$ $\,$ Eurocard/MasterCard$\:$ $\Box$
$\,$ American Express $\:$ $\Box$ $\,$ Diners Club
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\noindent
Card No. ...................................................
Expiration Date: ......................
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\noindent
Signature: ..................................
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\noindent
Card holder name: ................................................
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\noindent
Card holder address: .............................................
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\noindent
...............................................................................
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\noindent
Amount/currency: ................................................
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\noindent
{\bf Bank reference:}
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\noindent
Name of the bank: ....................................................
\quad City: .......................
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\noindent
Acount \#: ................................................................
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\noindent
Please return to: \phantom{A}
\begin{minipage}[t]{4in}
{\em QMath7 \\ Nuclear Physics Institute, Academy of Sciences \\ 
CZ--25068 \v{R}e\v{z} near Prague, Czech Republic}
\end{minipage}
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