REGISTRATION FORM FOR COPENHAGEN DREAMS The International Association for the Study of Dreams 21st Conference June 18-22, Copenhagen, Denmark CONFERENCE FEE The fee includes all program events June 18-22, 2004, basic conference material, an opening reception and the ever-popular closing costume Dream Ball. All are urged to register early for the 2004 conference to ensure space for certain limited attendance functions, as well as to take advantage of the discounts. Send a copy of this completed form to: ASD Copenhagen Sue Moreno ASD Central Office, P.O. Box # 1592 Merced, Ca. 95341-1592 =================================================== Speakers Rates 365 EUR ASD Member 460 EUR Non-Member (Fee includes 1 yr membership if requested) 290 EUR ASD Member Student/Limited Income * 350 EUR Non-Member Student/Limited Income* (Fee includes 1 yr membership if requested) ---------------------------------------------------- Register by 18st May 2004 [Note this rate extended Past 18 May for all on-line registration whether you pay On line or not - see post 18 may instructions below] 380 EUR ASD Member 475 EUR Non-Member (Fee includes 1 yr membership if requested) 300 EUR ASD Member Student/Limited Income * 360 EUR Non-Member Student/Limited Income* (Fee includes 1 yr membership if requested) ---------------------------------------------------- Register after 18st of May 2004 (note that if you register or have registered on-line, even if you mail-in your payment, the pre 18 May discount applies. To take advantage of this we suggest that you fill out the on-line form, then print it (before hitting the submit button), Then Submit and leave the payment page blank - your registration Will be captured. You can then use the printed out web form in leu of the form below to mail in with your payment). 400 EUR ASD Member 495 EUR Non-Member (Fee includes 1 yr membership if requested) 320 EUR ASD Member Student/Limited Income * 380 EUR Non-Member Student/Limited Income* (Fee includes 1 yr membership if requested) ---------------------------------------------------- * Limited Income is under 22.000 EUR annually. Students must provide copy of full-time student I.D. to qualify (send to Central Office address below referencing your on-line registration). ENTER FULL CONFERENCE FEE HERE________________ ----------------------------------------------------------------------------------------------------------------- 2 DAY ATTENDANCE OPTION: Yes I will only attend on _________ (specify which days) If you are only attending 2 days or less multiply the above fee by 0.7 and enter below ------------------------------------------------------------------------------------------------------------------- ENTER FINAL TOTAL CONFERENCE FEE HERE_______________________ =============================================================== If you are not an ASD member, please register as a member to take advantage of the discounted member rates, by going to the ASD Website [ http://www.asdreams.org/idxmembership.htm ] for on-line payment in $US - OR - simply pay the full non-member conference fee and take advantage of the complementary 1 year free membership that comes with it. Membership rates are shown below for refernce. ---------------------------------------------------------------------------------------------- Individual----- Included in Full Conference ---------- Value ($100 USD) Limited Income or Student ** - Included in Full Conference Value ($65 USD) Couple--------150 USD - register on ASDreams.org (receive 1 copy of publications) Patron-------- 150 USD ------register on ASDreams.org ================================================================ [ ] I AM AN ASD MEMBER I AM A NON-MEMBER PAYING THE FULL CONFERENCE FEE, PLEASE REGISTER ME FOR THE 1 YR. COMPLEMENTARY MEMBERSHIP [ ] YES [ ] NO ================================================================ MEALS Lunch and dinner will be offered at a boat restaurant next to the venue. Please indicate, which days you are interested in buying lunch and/or dinner. Ordering will be accepted only until June 5. Lunch for June 19-21 is sandwiches, for June 22 is a traditional Danish lunch buffet. Dinner tickets for June 19, 20 and 22 is a basic buffet. Price per ticket, excludes drinks. Total pay per meal (please check box): June 19 Lunch 8 EUR [ ] Dinner 17 EUR [ ] June 20 Lunch 8 EUR [ ] Dinner 17 EUR [ ] June 21 Lunch 8 EUR [ ] June 22 Lunch 14 EUR [ ] Dinner 17 EUR [ ] If you are a vegetarian, please indicate here [ ] ENTER TOTAL MEAL PAYMENT HERE_____________________ =================================================================== JUNE 23RD EVENT Please indicate if you want to participate in the post-conference special summer solstice excursion on the evening of June 23 or 23rd. The fee for transport, evening drinks and snacks is EUR 30. Limited attendance. June 23rd 30 EUR per person Number of Persons__________ Enter TOTAL EVENT FEE______ =================================================================== C.E.U. Fees (for those wishing an ASD continuing education unit certificate) Full Conference: 30 EUR [ ] Enter C.E.U. Fees here _______ =================================================================== Accommodations: http://asdreams.org/2004/idx_transportation.htm#ACCOMMODATIONS To link upwith a roommate log on to the Bulletin Board on the ASD Website: =================================================================== REGISTRATION/PAYMENT INFORMATION Name on Credit Card Street Address where credit card is billed City State Province or Territory if needed Zip or Postal Code Country E-mail Day Phone Evening Phone Fax Website ===================================================================== Registration Address Information if different from Credit Card information: Name on Credit Card Street Address where credit card is billed Street Address 2 if needed City State Province or Territory if needed Zip or Postal Code Country E-mail Day Phone Evening Phone Fax Website ================================================================= May we share your name and address information on a list to be given to conference attendees? [ ]YES [ ]NO ================================================================= Note: An administrative fee of 100 EUR will be charged for all cancellations ================================================================= Credit Card Number______________________________________________ CVC Control Number (3 Numbers on back of card)________ Amount in EUR on Credit Card_____________________________________ Expiration month and year________________________________________ [ ] Check or Money Order enclosed ================================================================== SEND TO: ASD Copenhagen Sue Moreno ASD Central Office, P.O. Box # 1592 Merced, Ca. 95341-1592