GAMEON-NA'2008 Registration Form

(Or use the fax registration form)

Please note: This form does NOT work with Internet Explorer 3.02 or lower. It does work fine with all versions of Firefox and higher versions of Explorer.

If e-mail fails, you can also print this information and send / fax it to:
Philippe Geril, EUROSIS-ETI,
European Simulation Office
Greenbridge NV
Wetenschapspark 1,
Plassendale 1 , B-8400, Ostend, Belgium.
Phone: +32-59-255.330, Fax: +32-59-255.339

Personal Information

user email

Conference Information

PRE-CONFERENCE PRICES VALID TILL JULY 25. After JULY 25, prices will be CAD 50 higher.

Specify your member number

Payment information
JULY-25-by-BANK-TRANSFER-to-account-No.-001-4081477-84--European-Technology-Institute,-ETI-Bvba,-FORTIS-BANK,-Torhoutsesteenweg-195,-B-8400-Ostend,-Belgium-IBAN-CODE:-BE03-0014-0814-7784,-SWIFT-CODE:-GEBABEBB-:-001-4081477-84-MENTION-YOUR-NAME-and-GAMEON-NA-2008-(make-a-print-of-this-form-so-you-know-what-you-submitted)-and-ADD-A-COPY-OF-PAYMENT-TO-THIS-FORM-wrapper">
Credit card information

Optional

CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.
1 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.