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REGISTRATION

¡EDELEGATE INFORMATION
¡EName ¡ETitle
ex: First name- Middle name- Last name ¡EFax
Male Female ¡EE-mail
¡EOrganization ¡ETel
¡EMailing Address


¡EREGISTRATION FEE
„Ë You won¡¦t miss anything with the full registration package. Includes admission to all sessions, exhibits four receptions, two luncheons, Banquet (July 21), and all Conference material including a copy of the conference proceeding.
On or Before June 10 Early US$120 (NT $3,600)
After June 11 Regular US$180 (NT $5,400)

¡EPAYMENT
Bank Draft  Account Name HL7 Taiwan
Account No 679-53011203-5
Bank Name CHINATRUST COMMERCIAL BANK
SWIF CODE CTCBTWTP
Bank's ADD 1F., No.161, Sec. 4, Nanjing E. Rd., Songshan District, Taipei City 105, Taiwan.
¡¯Please fax this form no later than July 08, 2005 to the Conference Secretariat¡¯
Credit Card Online registration.

International Affiliate Chair or designated representative

¡ECONFERENCE SECRETARIAT
HL7 Taiwan
Room 3, 12F, No. 20, Minchung W. Rd., Taipei, Taiwan 104
Tel¡G+886-2-2523-3900
Fax¡G+886-2-2521-9790
E-mail¡GHL7TW2005CONF@HL7.ORG.TW
Website¡GHTTP://WWW.HL7.ORG.TW
SIGNATURE:_________________________________ DATE: __________________________________
 
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