FOODSIM 2008

Dublin, Ireland, 26-28 June  2008

FAX/MAIL REGISTRATION FORM
 


 

 

 

 

Please legibly print or type and fill out completely.

FIRST NAME
 
LAST NAME
 
M.I.
 
COMPANY OR AFFILIATION
 
Mailing address (tick one): [ ] HOME [ ] BUSINESS
STREET
 
CITY
 
ZIPCODE
 
COUNTRY
 
TELEPHONE
 
FAX
 
E-MAIL
 
DATE
 
SIGNATURE
 

PRICES VALID TILL JUNE 5th. After June 5th, prices will be 10% higher.

REGISTRATION AND PAYMENT
CONFERENCE REGISTRATION
(Check appropriate boxes)
1. [ ] EUROSIS member € 485
Member Number:_____________________________
€__________
2. [ ] Members of Sponsor or Affiliate Society € 485
Circle your affiliation: SISO
€__________
3. [ ] Non-Member Participant € 545 €__________
4. [ ] Students, who are not authors but who wish to attend the conference, or ONE DAY PARTICIPANTS pay: € 350 €__________
(Above registration fees include, one copy of the PROCEEDINGS, all midday meals, cocktail, refreshments, coffees 
and social program,) One Day Participants and Non-Author Students cannot participate in the conference dinner.
 
5. [ ] Conference Dinner Ticket for Companion € 60 €__________
6. [ ] Extra Conference Proceedings € 50 €__________
VAT Number if applicable: _______________________________
TOTAL AMOUNT DUE €__________
ADD BANK CHARGE of € 15 in case you pay by BANK or CHEQUE. €__________
TOTAL AMOUNT REMITTED €__________

[ ] 1)

Make payment 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 FOODSIM'2008
[ ] 2) Or pay by CHEQUE and send it to Philippe Geril, EUROSIS-ETI, European Simulation Office, Greenbridge NV, Wetenschapspark 1, Plassendale 1,  B-8400 Ostend, Belgium.
[ ] 3) Or pay by CREDIT CARD and fill in the information below:
Charge my (tick one): [ ]Visa [ ] Euro/Mastercard [ ] American Express [ ]Diners

CARD NO: __ __ __ __ : __ __ __ __ : __ __ __ __ : __ __ __ __ EXP.DATE: __ __ / __ __

(CHECK THE NUMBER TO SEE IF IT IS CORRECT BEFORE YOU SEND IT THROUGH)

Authorizing Signature:
  
Print Signature in CAPITALS
 

PURCHASE ORDERS ARE NOT ACCEPTED UNLESS GUARANTEED BY A CREDIT CARD NUMBER.

MAIL REGISTRATION FORM AND PAYMENT FORM COPY (1) / CHEQUE (2) / CREDITCARD INFO (3) 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


Page created by Philippe Geril . Last update 23-06-08.
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