A s i a c r y p t 2 0 0 4,  D e c . 5-9 ,  2 0 0 4  Jeju , Korea

Hotel Reservation Form


The following hotels offer special rates to participants of the Asiacrypt 2004. 
To make your reservation, please complete the delegate information and return it by email to the email-address below.

1. Shilla Jeju Hotel : jejushilla@samsung.com

2. Suites Hotel : helper@suites.co.kr

3. Hotel Hana : hotelhana@hotmail.com



Delegate Information


 1. Name: Prof./Dr./Mr./Ms. _________________ ____________________ _________________
                              Last (Family)         First (Given)         Middle Initial
 2. Country: ____________________
 3. Organization: _____________________________________
 4. Address: _____________________________________________________________________
 5. Room Type:  ( )Single    ( )Double    ( )Twin 
 6. Telephone: __________________ 
 8. Fax: ________________
 8. E-mail: ______________________
 9. Accompanying or sharing person(s), if any:
     (1)______________________________ (2)_______________________________
10. Hotel check-in date:____________ 
11. check-out date: ____________   Total: _____night(s)
12. I will guarantee my reservation with:
     ( )Visa   ( )Master Card   ( )AE   ( )Diners Club
     Card No.:______________________________ Expiration Date[MM/YY]:________________
     Signature:_________________________ Date:___________________