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<!doctype html public "-//w3c//dtd html 4.0 transitional//en"> <html> <head> <META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=koi8-r"> <meta http-equiv="Content-Script=Type" content="text/javascript"> <meta name="Author" content="Sergiy Kolyada"> <title>Registration</title> <SCRIPT type="text/javascript" DEFER > function totalnights(){ var i1 = document.forms[1].arriveDate.selectedIndex; var i2 = document.forms[1].departDate.selectedIndex; var nights = document.forms[1].departDate.options[i2].value - document.forms[1].arriveDate.options[i1].value; if(nights >=0){ document.forms[1].nights.value = nights;} else{ alert("Really depart before arrive?\nCheck dates, please!"); } return true; } function calculatefee(){ var startfee = 40; var partyfee = 20; var banquetfee = 20; var travelfee = 20; var needparty = 0; if (document.forms[1].party.checked) needparty = 1; var numberparty = document.forms[1].partypersons.selectedIndex +1; var needbanquet = 0; if(document.forms[1].banquet.checked) needbanquet=1; var numberbanquet = document.forms[1].banquetpersons.selectedIndex +1; var needtravel = 0; if(document.forms[1].needtransport[0].checked) needtravel=1; var accompanies = document.forms[1].accompanies.selectedIndex; document.forms[1].fee_part.value = startfee + needparty * partyfee + banquetfee * needbanquet + travelfee * needtravel; document.forms[1].total_part.value = document.forms[1].fee_part.value; document.forms[1].total_acc.value = needparty * partyfee * (numberparty -1) + banquetfee * needbanquet * (numberbanquet -1) + travelfee * needtravel * accompanies; document.forms[1].total.value = startfee + needparty * partyfee * numberparty + banquetfee * needbanquet * numberbanquet + travelfee * needtravel * (accompanies +1); } </script> </head> <BODY BGCOLOR="#FFFFFF" ONLOAD="totalnights(); calculatefee();" TEXT="#000000"> <table BORDER WIDTH="100%" BGCOLOR="#009900" > <tr VALIGN=TOP> <td ALIGN=LEFT VALIGN=CENTER WIDTH="70%"><a href="http://www.imath.kiev.ua/~skolyada/kats2000.html"><img SRC="Koshkas1.jpg" ALT="logo" BORDER=0 height=100 width=145 align=CENTER></a><b><font face="Arial"><font size=+2><font color="#66FFFF">K A T S I V E L I 2 0 0 0 -- </font><font color="#FF0000">Registration Form</font></font></font></b></td> </tr> </table> <table BORDER WIDTH="100%" > <tr VALIGN=TOP> <td WIDTH="100%" BACKGROUND="oblbeg.jpg">.</td> </tr> </table> <p><b><font size=+1><font color="#CC0000">REGISTRATION</font><font color="#000000"> FORM FOR ONE PARTICIPANT</font></font></b> <P> You can update or change the data in this form later. To keep us informed about your plans, please, enter as much information as you can at the moment, and make all changes and addittions as soon as possible. <BR> To fill or update this form, personal key is needed. <A HREF="getkey.php3">Get your key</A> <BR> <FORM ACTION="authenticate.php3" METHOD=POST> <TABLE CELLSPACING="0"> <TR> <TD><b> Please, enter your personal key: </b></td> <TD><b><INPUT TYPE=password NAME="password" SIZE="10"> <INPUT TYPE=submit VALUE="submit"></b> </td> </tr> </table> </FORM> <FORM ACTION="register1.php3" METHOD="POST"> <table BORDER WIDTH="100%" > <tr VALIGN=TOP> <td COLSPAN="4" WIDTH="100%" BGCOLOR="#000066"><b><font color="#FFFFFF">PERSONAL INFORMATION</font></b></td> </tr> <tr VALIGN=TOP> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">Family Name:</font></td> <td WIDTH="29%"><input NAME="lastname" size=25 value=""></td> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">First Name:</font></td> <td WIDTH="29%"><input NAME="firstname" size=25 value="" ></td> </tr> <tr VALIGN=BOTTOM> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">Accompanying Person 1</font> <br><font color="#000000">Family Name:</font></td> <td WIDTH="29%"><input NAME="acomp_1_apellido" size=25></td> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">First Name:</font></td> <td WIDTH="29%"><input NAME="acomp_1_nombre" size=25></td> </tr> <tr VALIGN=BOTTOM> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">Accompanying Person 2</font> <br><font color="#000000">Family Name:</font></td> <td WIDTH="29%"><input NAME="acomp_2_apellido" size=25></td> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">First Name:</font></td> <td WIDTH="29%"><input NAME="acomp_2_nombre" size=25></td> </tr> <tr VALIGN=BOTTOM> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">Accompanying Person 3</font> <br><font color="#000000">Family Name:</font></td> <td WIDTH="29%"><input NAME="acomp_3_apellido" size=25></td> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">First Name:</font></td> <td WIDTH="29%"><input NAME="acomp_3_nombre" size=25></td> </tr> </table> <br> <table BORDER WIDTH="100%" > <tr VALIGN=TOP> <td COLSPAN="4" WIDTH="100%" BGCOLOR="#000066"><b><font color="#FFFFFF">AFFILIATION</font></b></td> </tr> <tr VALIGN=TOP> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">Institution</font></td> <td COLSPAN="3" WIDTH="79%"><input NAME="institution" size=60 value=""></td> </tr> <tr VALIGN=TOP> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">Faculty or Department:</font></td> <td COLSPAN="3" WIDTH="79%"><input NAME="faculty" size=60 value=""></td> </tr> <tr VALIGN=TOP> <td WIDTH="21%" BGCOLOR="#EFEFEF"><font color="#000000">Street or P.O.Box:</font></td> <td COLSPAN="3" WIDTH="79%"><input NAME="street" size=60 value=""></td> </tr> <tr VALIGN=TOP> <td WIDTH="15%" BGCOLOR="#EFEFEF"><font color="#000000">City:</font></td> <td WIDTH="15%"><input NAME="city" size=25 value=""></td> <td WIDTH="19%" BGCOLOR="#EFEFEF"><font color="#000000">Country:</font></td> <td WIDTH="50%"><input NAME="country" size=25 value=""></td> </tr> <tr VALIGN=TOP> <td WIDTH="25%" BGCOLOR="#EFEFEF"><font color="#000000">Zip Code:</font></td> <td WIDTH="25%"><input NAME="zip" size=25 value=""></td> <td WIDTH="25%" BGCOLOR="#EFEFEF"><font color="#000000">Phone:</font></td> <td WIDTH="25%"><input NAME="phone" size=25 value=""></td> </tr> <tr VALIGN=TOP> <td WIDTH="25%" BGCOLOR="#EFEFEF"><font color="#000000">Fax:</font></td> <td WIDTH="25%"><input NAME="fax" size=25 value=""></td> <td WIDTH="25%" BGCOLOR="#EFEFEF"><font color="#000000">E-mail:</font></td> <td WIDTH="25%"><input NAME="email" size=25 value=""></td> </tr> </table> <p><b><font color="#000000">Please give information about your and your accompayning persons passports for getting the visas to Ukraine</font></b> <table BORDER WIDTH="100%" > <tr VALIGN=TOP> <TD WIDTH="100%" COLSPAN=4 BGCOLOR="#000066"><b><font color="#FFFFFF">PASSPORT INFORMATION for VISAS</font></b></td> </tr> <TR> <TD COLSPAN=2><B>Participant's data:</B> <TD COLSPAN=2><INPUT TYPE=checkbox> I need a formal invitation letter <tr VALIGN=TOP> <TD>Passport No. </td> <TD><INPUT NAME="pass_p" SIZE="20"> <TD>Issued by <TD><INPUT NAME="pass_p_au" SIZE="30"> </tr> <TR> <TD>Date of issue (YYYY-MM-DD) <TD><INPUT NAME="pass_p_is" SIZE="10"> <TD>Date of expire (YYYY-MM-DD) <TD><INPUT NAME="pass_p_ex" SIZE="10"> <TR> <TD>Date of birth (YYYY-MM-DD) <TD><INPUT NAME="pass_p_dob" SIZE="10"> <TD>Place of birth (YYYY-MM-DD) <TD><INPUT NAME="pass_p_pob" SIZE="10"> <TR> <TD COLSPAN=4><B>1-st accompanion person's data:</B> <tr VALIGN=TOP> <TD>Passport No. </td> <TD><INPUT NAME="pass_p" SIZE="20"> <TD>Issued by <TD><INPUT NAME="pass_p_au" SIZE="30"> </tr> <TR> <TD>Date of issue (YYYY-MM-DD) <TD><INPUT NAME="pass_p_is" SIZE="10"> <TD>Date of expire (YYYY-MM-DD) <TD><INPUT NAME="pass_p_ex" SIZE="10"> <TR> <TD>Date of birth (YYYY-MM-DD) <TD><INPUT NAME="pass_p_dob" SIZE="10"> <TD>Place of birth (YYYY-MM-DD) <TD><INPUT NAME="pass_p_pob" SIZE="10"> <TR> <TD COLSPAN=4><B>2-nd accompanion person's data:</B> <tr VALIGN=TOP> <TD>Passport No. </td> <TD><INPUT NAME="pass_p" SIZE="20"> <TD>Issued by <TD><INPUT NAME="pass_p_au" SIZE="30"> </tr> <TR> <TD>Date of issue (YYYY-MM-DD) <TD><INPUT NAME="pass_p_is" SIZE="10"> <TD>Date of expire (YYYY-MM-DD) <TD><INPUT NAME="pass_p_ex" SIZE="10"> <TR> <TD>Date of birth (YYYY-MM-DD) <TD><INPUT NAME="pass_p_dob" SIZE="10"> <TD>Place of birth (YYYY-MM-DD) <TD><INPUT NAME="pass_p_pob" SIZE="10"> <TR> <TD COLSPAN=4><B>3-rd accompanion person's data:</B> <tr VALIGN=TOP> <TD>Passport No. </td> <TD><INPUT NAME="pass_p" SIZE="20"> <TD>Issued by <TD><INPUT NAME="pass_p_au" SIZE="30"> </tr> <TR> <TD>Date of issue (YYYY-MM-DD) <TD><INPUT NAME="pass_p_is" SIZE="10"> <TD>Date of expire (YYYY-MM-DD) <TD><INPUT NAME="pass_p_ex" SIZE="10"> <TR> <TD>Date of birth (YYYY-MM-DD) <TD><INPUT NAME="pass_p_dob" SIZE="10"> <TD>Place of birth (YYYY-MM-DD) <TD><INPUT NAME="pass_p_pob" SIZE="10"> </table> <p> <b> <font color="#000000">Please give a full information about your and your accompayning trip to Katsiveli </font> </b> <table BORDER WIDTH="100%" > <tr VALIGN=TOP> <td COLSPAN="3" BGCOLOR="#000066"><b><font color="#FFFFFF">TRAVEL INFORMATION </font></b></td> </tr> <tr VALIGN=TOP> <TD VALIGN=top><INPUT TYPE=radio NAME="wheretogo">First I will arrive to Kiev, and I need <td><INPUT TYPE=checkbox> ticket reservation to get to Simferopol and back by <SELECT><OPTION>air<OPTION>train</SELECT> <BR><INPUT TYPE=checkbox> hotel reservation to stay in Kiev </tr> <TR> <TD VALIGN=top><INPUT TYPE=radio CHECKED NAME="wheretogo">I will arrive to Simferopol directly and <TD><INPUT TYPE=radio CHECKED NAME="needtransport" VALUE="0" ONCLICK="calculatefee();">need transtoportation to Katsiveli and back <BR>Arrival date: <SELECT><OPTION>Aug 19<OPTION SELECTED>Aug 20<OPTION>Aug 21<OPTION>Aug 22</SELECT> by <SELECT><OPTION>air<OPTION>train</SELECT> at <INPUT SIZE="5"> <BR><INPUT TYPE=radio NAME="needtransport" VALUE="1" ONCLICK="calculatefee();">get to Katsiveli and back myself </table> <p> <table BORDER WIDTH="100%" > <tr VALIGN=TOP> <td COLSPAN="2" WIDTH="100%" BGCOLOR="#000066"><b><font color="#FFFFFF">PUBLICATIONS </font></b></td> </tr> <tr VALIGN=TOP> <td WIDTH="50%">If you are going to present a paper to the Proceedings or (if you are a speaker of mini-coures) to the Notices of the conference please submit a LaTeX file with a short abstract.</td> <TD><INPUT TYPE=file NAME="abstractfile" SIZE="30"></td></tr> <tr> <TD>or input the title and a short abstract manually <td><INPUT SIZE="50"><BR><textarea NAME="Comments" ROWS=7 COLS=50></textarea></td> </tr> </table> <p><b><font color="#000000">Please mark the social events that you and/or your companions will probably attend (the cost of social events is included in the registration fee)</font></b> <br> <table BORDER WIDTH="100%" > <tr VALIGN=TOP> <TD COLSPAN=2 BGCOLOR="#000066"><b><font color="#FFFFFF">SOCIAL EVENTS </font></b></td> </tr> <tr VALIGN=TOP> <td WIDTH="50%" BGCOLOR="#EFEFEF"><b><font color="#000000"> <INPUT TYPE=checkbox NAME="party" VALUE="1" ONCLICK="calculatefee();"> Welcome party, </font></b><SELECT NAME="partypersons" ONCHANGE="calculatefee();"> <OPTION VALUE="1" SELECTED>1<OPTION VALUE="2">2<OPTION VALUE="3">3<OPTION VALUE="4">4</SELECT> persons</td> <td WIDTH="50%" BGCOLOR="#EFEFEF"><b><font color="#000000"> <INPUT TYPE=checkbox NAME="banquet" ONCLICK="calculatefee();"> Banquet, </font></b><SELECT NAME="banquetpersons" ONCHANGE="calculatefee();"> <OPTION VALUE="1" SELECTED>1<OPTION VALUE="2">2<OPTION VALUE="3">3<OPTION VALUE="4">4</SELECT> persons</td> </tr> </table> <br> <table BORDER COLS=1 WIDTH="100%" BGCOLOR="#000066" > <tr> <td><b><font color="#FFFFFF"><font size=+1>ACCOMMODATION</font></font></b></td> </tr> </table> <p><font color="#000000"><b>Accommodation prices (per night) are the following</b>:</font> <br><!-- hoteles --> <table BORDER WIDTH="100%" BGCOLOR="#FFFFFF" > <tr ALIGN=LEFT VALIGN=TOP BGCOLOR="#C0C0C0"> <td ALIGN=CENTER WIDHT="10%"><b><font color="#000000">CODE </font></b></td> <td ALIGN=CENTER WIDHT="10%"><b><font color="#000000">ACCOMMODATION </font></b></td> <td ALIGN=CENTER WIDHT="40%"><b><font color="#000000">DOUBLE ROOM (Prices)</font></b></td> <td ALIGN=CENTER WIDHT="40%"><b><font color="#000000">SINGLE ROOM (Prices)</font></b></td> </tr> <tr VALIGN=TOP> <td ALIGN=CENTER BGCOLOR="#EFEFEF" WIDHT="10%">A</td> <td BGCOLOR="#EFEFEF" WIDHT="10%">Summer Residance</td> <td ALIGN=CENTER WIDHT="40%">25 USD/person</td> <td ALIGN=CENTER WIDHT="40%">50 USD</td> </tr> <tr VALIGN=TOP> <td ALIGN=CENTER BGCOLOR="#EFEFEF" WIDHT="10%">B</td> <td BGCOLOR="#EFEFEF" WIDHT="10%">Other Hotel </td> <td ALIGN=CENTER WIDHT="40%">< 25 USD </td> <td ALIGN=CENTER WIDHT="40%">> 50 USD</td> </tr> <tr VALIGN=TOP> <td ALIGN=CENTER BGCOLOR="#EFEFEF" WIDHT="10%">C</td> <td BGCOLOR="#EFEFEF" WIDHT="10%">Private Apartments</td> <td ALIGN=CENTER WIDHT="40%">Approx 5 USD/person</td> <td ALIGN=CENTER WIDHT="40%">Approx 10 USD/person</td> </tr> </table> <p><font color="#000000">Prices of double rooms are the same if they are occupied by one or two people. Thus, there is an advantage if two people decide to share a double room, and indicate it clearly on their respective registration forms.</font> <p><b><font color="#000000">Please fill in the following data</font></b> <table BORDER WIDTH="100%" > <tr VALIGN=TOP BGCOLOR="#C0C0C0"> <td COLSPAN="3"><b><font color="#000000">HOTEL RESERVATION</font></b></td> </tr> <tr VALIGN=TOP> <td WIDHT="33%">Arrival Date: <SELECT NAME="arriveDate" ONCHANGE="totalnights()"> <OPTION VALUE="1">Aug 19 <OPTION VALUE="2" SELECTED>Aug 20 <OPTION VALUE="3">Aug 21 <OPTION VALUE="4">Aug 22 <OPTION VALUE="5">Aug 23 <OPTION VALUE="6">Aug 24 <OPTION VALUE="7">Aug 25 <OPTION VALUE="8">Aug 26 <OPTION VALUE="9">Aug 27 </SELECT> </td> <td WIDHT="33%">Departure Date: <SELECT NAME="departDate" ONCHANGE="totalnights()"> <OPTION VALUE="6">Aug 24 <OPTION VALUE="7">Aug 25 <OPTION VALUE="8">Aug 26 <OPTION VALUE="9">Aug 27 <OPTION VALUE="10">Aug 28 <OPTION VALUE="11">Aug 29 <OPTION VALUE="12" SELECTED>Aug 30 <OPTION VALUE="13">Aug 31 <OPTION VALUE="14">Sep 1 </SELECT> </td> <td WIDHT="33%">Total Nights:<INPUT NAME="nights" SIZE="2" ONFOCUS="totalnights()" ONBLUR="totalnights()" ONSELECT="alert('no changes here!'); totalnights()" ONCHANGE="alert('no changes here!'); totalnights()" ONCLICK="totalnights()" ONKEYDOWN="totalnights()" ONKEYPRESS="totalnights()" ONKEYUP="totalnights()"></td> </tr> <tr VALIGN=TOP> <td WIDHT="33%">Hotel Code:<SELECT> <OPTION SELECTED DISABLED>--<OPTION>A<OPTION>B<OPTION>C </SELECT> </td> <td WIDHT="33%">No. of Double Rooms: <SELECT> <OPTION SELECTED>--<OPTION>1<OPTION>2<OPTION>3 </SELECT> </td> <td WIDHT="33%">No. of Single rooms: <SELECT> <OPTION SELECTED>--<OPTION>1<OPTION>2<OPTION>3 </SELECT></td> </tr> <tr VALIGN=TOP> <td COLSPAN="3"><INPUT TYPE=checkbox> I wish to share a double room with another participant. <BR>Name: <input NAME="nom_compartir_hab__hotel" size=50></td> </tr> <tr VALIGN=TOP> <TD VALIGN=top COLSPAN=3>Comments:<BR><TEXTAREA COLS=68 ROWS=3 NAME="Comments"></textarea></td> </tr> </table> Unfortunately, we cannot accept payments for living expenses now; payment will be made during registration <br> <table BORDER COLS=1 WIDTH="100%" BGCOLOR="#000066" > <tr> <td><b><font color="#FFFFFF"><font size=+1>CONFERENCE REGISTRATION</font></font></b></td> </tr> </table> <p><b><font color="#000000">Registration Fees. Please fill in the following data in USD</font></b> <br> <table BORDER WIDTH="100%" > <tr VALIGN=TOP> <td WIDTH="30%" BGCOLOR="#EFEFEF"></td> <td ALIGN=CENTER WIDTH="20%" BGCOLOR="#EFEFEF"><b><font color="#000000">Fee per Person</font></b></td> <td ALIGN=CENTER WIDTH="20%" BGCOLOR="#EFEFEF"><b><font color="#000000">Total USD</font></b></td> </tr> <tr VALIGN=TOP> <td WIDTH="30%" BGCOLOR="#EFEFEF"><font color="#000000">Participant:</font></td> <td ALIGN=CENTER WIDTH="20%"><INPUT NAME="fee_part" SIZE="5" READONLY></td> <td ALIGN=CENTER WIDTH="20%"><INPUT NAME="total_part" SIZE="5"></td> </tr> <tr VALIGN=TOP> <td WIDTH="30%" BGCOLOR="#EFEFEF"><font color="#000000">Accompanying People:</font> <SELECT NAME="accompanies" ONCHANGE="calculatefee();"> <OPTION SELECTED>--<OPTION>1<OPTION>2<OPTION>3</SELECT> persons </td> <TD WIDTH="35%" ALIGN=center><INPUT NAME="fee_acc" SIZE="5" READONLY></td> <TD WIDTH="35%" ALIGN=center><INPUT NAME="total_acc" SIZE="5" READONLY></td> </tr> <tr VALIGN=TOP> <TD WIDTH="50%"> </td> <TD ALIGN=center BGCOLOR="#EFEFEF"><b><font color="#000000">Total: </font></b></td> <TD ALIGN=center><INPUT NAME="total" SIZE="10"></td> </tr> </table> <TABLE FRAME=void RULES=none> <TR> <Td>I will pay <TR> <TD COLSPAN=2><INPUT TYPE=radio>By bank transfer (preferred) to <TR> <TD WIDTH="10%"> <TD>Some Bank<BR>Some account<BR>SWIFT .... <TR> <TD><INPUT TYPE=radio>By cache upon arrival </TABLE> <br> <table BORDER WIDTH="100%" > <tr VALIGN=TOP> <td ALIGN=LEFT WIDTH="20%" BGCOLOR="#000066"><b><font color="#FFCC00">Your personal data will only be used for information purposes related to the Katsiveli 2000</font></b></td> </tr> </table> <table BORDER=0 CELLSPACING=0 WIDTH="100%" > <tr VALIGN=TOP> <td ALIGN=RIGHT><input TYPE=submit name="reply" VALUE="Register"></td> <td ALIGN=LEFT><input type=submit name="reply" value="Cancel"></td> </tr> </table> <p><A HREF="payment.html" NAME="Click here to retrieve the payment form"></a><a NAME="Click here to retrieve the payment form" href="http://www.imath.kiev.ua/~skolyada/pay_form.html"></a><a NAME="Click here to retrieve the payment form" href="http://www.imath.kiev.ua/~skolyada/pay_form.html"></a><b><font color="#000000"><a href="http://www.imath.kiev.ua/~skolyada/pay_form.html" NAME="Click here to retrieve the payment form">Click here to retrieve the payment form</a></font></b> <center><table BORDER COLS=1 BGCOLOR="#347787" > <tr> <td ALIGN=LEFT VALIGN=BASELINE><a href="http://www.imath.kiev.ua/~skolyada"><img SRC="homepage.gif" HSPACE=2 BORDER=0 height=12 width=14></a><font size=-2><font face="Comic Sans MS"> Last updated February 2, 2000 Send any comments or questions to <a href="http://www.imath.kiev.ua/~skolyada/mailaddr.html"><img SRC="mail.gif" ALT="Mail address" HSPACE=2 BORDER=0 height=51 width=44></a> </font><a href="mailto:skolyada@imath.kiev.ua">skolyada@imath.kiev.ua</a></font></td> </tr> </table></center> </form> </body> </html>