REGISTRATION FORM

                         STRUCTURAL CHEMISTRY INDABA

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   Intermolecular Interactions
   3-8 AUGUST 1997
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   Title:_____________________________________________________

   Initials:__________________________________________________

   Surname:___________________________________________________

   Institute:_________________________________________________
      

   Postal Address:____________________________________________

                  ____________________________________________

   e=mail:____________________________________________________

   Tel:_______________________________________________________

   Fax:_______________________________________________________

   Do you wish to present a paper?    Yes____   No____

                           Poster____  Oral Presentation____

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   REGISTRATION FEE:
   --------------------------------------+--------------------
   Full delegates           @ $280(330)  |   
   Acc. person / young sci. @ $100       |   
   airport shuttle          @ $100       |   
   Banquet                  @ $30        |   
   Accomd Advance                        |   
   Deposit:  luxury         @ $150       |   
             standard       @ $75        |   
             basic          @ $65        |   
   --------------------------------------+--------------------
   Total Due                             |   
   --------------------------------------+--------------------
   Total Submitted                       |   
   --------------------------------------+--------------------

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   TRAVEL DETAILS:       Airline:_____________________________

   Flight number:_______________   Arrival at jhb:__________________

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   CANCELLATIONS:  The following penalties will apply:
         Cancellation before 31st July   |   50%
         Cancellation after 31st July    |   No refund

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Please mail to:
                           Lesley Stephenson
                           Structural Chemistry Indaba
                           CEE Conference Office
                           PO Box 327
                           Wits University
                           WITS 2050
                           South Africa
                
          
or fax to:
                           Lesley Stephenson
                           Structural Chemistry Indaba
                           CEE Conference Office
                           fax: +27-11-716-7835

Before 15th June 1997