REGISTRATION
Registration form
Please fill in registration form below.
* Required
PARTICIPANT
Please, specify Your title:
Prof.
Dr.
Mr.
Mrs.
Family name:
*
First name:
*
Company:
*
E-mail:
*
Address:
Country:
Agreement for printing your email address on the participants list:
*
In respect with article 27 of French law « Informatique et Libertés » you have access to your data and may correct them. Unless you disagree, this information can be transferred to any interested person.
Yes
No
REGISTRATION
Participation to the conference on September 25, 2012:
*
Yes
No
Participation to the conference on September 26, 2012:
*
Yes
No
SPECIAL REQUIREMENTS
Vegetarian:
Yes
No
Any particular need for auxiliary aids or services?
REGISTRATION FEES (19.6% VAT included)
Registration fees include conference participation, proceedings, lunches and coffee breaks. Please mark the appropriate box.
Please choose one of the registration options below:
*
Student Conference Participant - 25 and/or 26 September 2012 (50 EUR)
Conference Participant - one day 25 OR 26 September 2012 (100 EUR)
Conference Participant - two days 25 AND 26 September 2012 (150 EUR)
Payment information (please tick):
*
PayPal through Conference Web site
Bank Transfer (details on Conference Web site)
CANCELLATION
Fees will be refunded for any written cancellation postmarked no later than 8 days before the beginning of the conference. No refund will be made in respect of cancellation received after this date.