Nominal/activities/tphols09/registration/reg.html
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     1 <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
       
     2 <html>
       
     3 <head>
       
     4 <title>TPHOLs 2009 Registration</title>
       
     5 </head>
       
     6 
       
     7 <BODY TEXT="#000000" 
       
     8       BGCOLOR="#4169E1" 
       
     9       LINK="#0000EF" 
       
    10       VLINK="#51188E" 
       
    11       ALINK="#FF0000">
       
    12 
       
    13 <TABLE WIDTH="100%" 
       
    14        BGCOLOR="#4169E1" 
       
    15        BORDER="0"   
       
    16        FRAME="border"  
       
    17        CELLPADDING="10"     
       
    18        CELLSPACING="2"
       
    19        RULES="all">
       
    20 
       
    21 <!-- left column -->
       
    22 <TR>
       
    23 <TD BGCOLOR="#FFFFFF" 
       
    24     WIDTH="20%" 
       
    25     VALIGN="TOP" 
       
    26     ROWSPAN="2">
       
    27    
       
    28 <p align=center>
       
    29 <a href="../pictures/marienplatz.jpg">
       
    30 <img src="../pictures/marienplatz_small.jpg" alt="Marienplatz" border=0></a>
       
    31 <br>
       
    32 <small>Marienplatz (city centre)</small><br>
       
    33 </p>
       
    34 
       
    35 <p align=center>
       
    36 <a href="../pictures/englischer_garten.jpg">
       
    37 <img src="../pictures/englischer_garten_small.jpg" alt="Englischer Garten" border=0></a>
       
    38 <br>
       
    39 <small>The English Garden</small><br>
       
    40 </p>
       
    41 
       
    42 <p align=center>
       
    43 <a href="../pictures/chinesischer_turm.jpg">
       
    44 <img src="../pictures/chinesischer_turm_small.jpg" alt="Chinesischer Turm" border=0></a>
       
    45 <br>
       
    46 <small>Chinese Tower (famous beer garden)</small><br>
       
    47 </p>
       
    48 
       
    49 <p align=center>
       
    50 <a href="../pictures/cs_building.jpg">
       
    51 <img src="../pictures/cs_building_small.jpg" alt="Computer science building" border=0></a>
       
    52 <br><small>The Computer Science building of the TUM</small><br>
       
    53 </p>
       
    54 
       
    55 <p align=center>
       
    56 <a href="../pictures/magistrale.jpg">
       
    57 <img src="../pictures/magistrale_small.jpg" alt="Main hall of the computer science building" border=0></a>
       
    58 <br>
       
    59 <small>The main hall in the CS-building</small><br>
       
    60 </p>
       
    61 
       
    62 <p align=center>
       
    63 <a href="../pictures/isar.jpg">
       
    64 <img src="../pictures/isar_small.jpg" alt="The river Isar" border=0></a>
       
    65 <br>
       
    66 <small>The Isar river</small><br>
       
    67 </p>
       
    68 
       
    69 <p align=center>
       
    70 <A HREF="../pictures/tphols09_poster.jpg">
       
    71 <IMG ALT="poster" SRC="../pictures/tphols09_poster_small.jpg" align="top"></A>
       
    72 <BR>
       
    73 <small>The conference poster</small><br>
       
    74 </p>
       
    75 
       
    76 </TD>
       
    77 
       
    78 
       
    79 <!-- right column -->
       
    80 <TD BGCOLOR="#FFFFFF" WIDTH="75%" VALIGN="TOP">
       
    81 
       
    82 <CENTER>
       
    83 [<a href="../index.html#dates">Important Dates</a>]
       
    84 [<a href="../index.html#submission">Paper Submission</a>]
       
    85 [<a href="../index.html#committees">Committees</a>]
       
    86 [<a href="../index.html#venueandprogramme">Venue and Programme</a>]
       
    87 [<a href="../index.html#workshops">Workshops</a>]
       
    88 [<a href="../index.html#travelandaccommodation">Travel and Accommodation</a>]
       
    89 [<a href="../index.html#registration">Registration</a>]
       
    90 [<a href="../index.html#support">Our Sponsors</a>]
       
    91 </CENTER>
       
    92 <HR><p>
       
    93 
       
    94 
       
    95 <h1>TPHOLs 2009 Registration</h1>
       
    96 
       
    97 <form method="post" action="confirm.php">
       
    98 <dl class="info">
       
    99 <dt><b>Contact Information</b></dt>
       
   100 <p>
       
   101 <dd>
       
   102 <table>
       
   103 <tr><td width="250">Title</td>
       
   104 <td><input name="title" type="text" size="30"></td></tr>
       
   105 <tr><td>First name *</td>
       
   106 <td><input name="firstName" type="text" size="30"></td></tr>
       
   107 <tr><td>Last name *</td>
       
   108 <td><input name="lastName" type="text" size="30"></td></tr>
       
   109 <tr><td>Email address *</td>
       
   110 <td><input name="email" type="text" size="30"></td></tr>
       
   111 <tr><td>Phone number</td>
       
   112 <td><input name="phone" type="text" size="30"></td></tr>
       
   113 <tr><td>Fax number</td>
       
   114 <td><input name="fax" type="text" size="30"></td></tr>
       
   115 </table>
       
   116 </dd>
       
   117 <p>
       
   118 <dt><b>Billing Address (if different from the one specified at M&uuml;nchenTicket)</B></dt>
       
   119 <p>
       
   120 <dd> 
       
   121 <table>
       
   122 <tr><td width="250">Organisation</td>
       
   123 <td><input name="organisation" type="text" size="30"></td></tr>
       
   124 <tr><td>Street / P.O. Box</td>
       
   125 <td><input name="street" type="text" size="30"></td></tr>
       
   126 <tr><td>City</td>
       
   127 <td><input name="city" type="text" size="30"></td></tr>
       
   128 <tr><td>Postal/ZIP code</td>
       
   129 <td><input name="postcode" type="text" size="30"></td></tr>
       
   130 <tr><td>Country</td>
       
   131 <td><input name="country" type="text" size="30"></td></tr>
       
   132 </table>
       
   133 </dd>
       
   134 <p>
       
   135 <dt><b>Registration Information</b></dt>
       
   136 <p>
       
   137 <dd>
       
   138 <table> <tr><td width="250">Registration Type</td>
       
   139 <td><select name="regType" size="1">
       
   140 <option value="conf">Conference (Regular)</option>
       
   141 <option value="confws">Conference + Workshop (Regular)</option>
       
   142 <option value="confstud">Conference (Student)</option>
       
   143 <option value="confwsstud">Conference + Workshop (Student)</option>
       
   144 <option value="ws">Workshop only</option>
       
   145 </select></td></tr>
       
   146 <tr><td width="250">Poster/Paper</td>
       
   147 <td><select name="posterpaper" size="1">
       
   148 <option value="poster">Poster</option>
       
   149 <option value="paper">Paper</option>
       
   150 <option value="NONE">NONE</option>
       
   151 </select></td></tr>
       
   152 <tr><td width="250">Special dietary requirements:<br><em>(e.g. vegetarian)</em></td>
       
   153 <td><input name="dietaryRequirements" type="text" size="30"></td></tr>
       
   154 <tr><td>Special needs:<br><em>(e.g. wheelchair access)</em></td>
       
   155 <td><input name="specialNeeds" type="text" size="30"></td></tr>
       
   156 <tr><td>Name to appear on Badge: *<br></td>
       
   157 <td><input name="badgeName" type="text" size="30"></td></tr>
       
   158 </table>
       
   159 </dd>
       
   160 <p>
       
   161 <dt><b>Submit Information</B></dt>
       
   162 <p>
       
   163 <dd>
       
   164 <table>
       
   165 <tr><td width="250">&nbsp;</td>
       
   166 <td><input type="submit" value="Submit"></td></tr>
       
   167 <tr><td>* Required fields.</td></tr>
       
   168 </table>
       
   169 </dd>
       
   170 </dl>
       
   171 </form>
       
   172 
       
   173 </TD>
       
   174 </TABLE>
       
   175 
       
   176 <hr>
       
   177 <!-- Created: Wed May  6 18:00:59 CEST 2009 -->
       
   178 <!-- hhmts start -->
       
   179 Last modified: Tue May 12 00:16:58 CEST 2009
       
   180 <!-- hhmts end -->
       
   181 <a href="http://validator.w3.org/check/referer">[Validate this page.]</a>
       
   182 </body>
       
   183 </html>