PREREGISTRATION FORM
  The 22nd International Conference on High Resolution Molecular Spectroscopy
              Prague, Czech Republic, September 4-8, 2012

                    Please use BLOCK LETTERS or typewriter

Last name:       ________________________________________________________

First name:      ________________________________________________________

Department:      ________________________________________________________

Institution:     ________________________________________________________

Street address:  ________________________________________________________

Postal code:     ______________ City: ___________________________________

State:           ______________________ Country: ________________________

Telephone:       ______________________   Fax:   ________________________

Electronic mail: ________________________________________________________
				         _
I plan to attend the  PRAHA2012 meeting |_| accompanied by  _______
person(s) who will not participate in the scientific part of the meeting.
					     _
I would like to receive the second circular |_|
                _                          _                 _
I am a student |_| a post-doctoral fellow |_| none of these |_|

I will require, as far as I can presently plan, the following type of
accommodation:

                       Single room           Double room
--------------------------------------------------------------
                                      _                      _
Student dormitory      Kc 700 -1100  |_|     Kc 500 -700    |_|
                                      _                      _
Hotel ***              Kc 1600-2000  |_|     Kc 1000-1500   |_|
                                     _
I do not require any accommodation  |_|
					   _
I would be willing to share a double room |_| (Roommate can be specified 
at final registration).

The actual reservations must be made on forms that will be distributed with 
the second circular; by filling out this preregistration form you help us 
assess the demand for different types of accommodation. We quote here 
estimates of the expected rates per person per day (breakfast included).
In October 2011, 100 CZK is approximately equivalent to EUR 4.05, USD 5.45
and GBP 3.50.