Please register me for ICEFA III 2008

Delegate Details

Title (Prof., Dr, Mr, Ms): Family Name: First Name: Job Title: Organisation: Address: Post/Zip code: Country: Telephone: Fax: Email: Special access or
dietary requirements:

Presenters should provide their abstract reference number in order to ensure that their material is included in the final program and abstract book
Ref:
Please do not include my name and affiliation in the list of attendees.

Registration Rate

Special 15% discount for registrations received by 30 April, 2008...

Early Bird Delegate Rate €545 + VAT @ 16% = €632.20
Early Bird Student Rate* €395 + VAT @ 16% = €458.20

For registrations received after 30 April, 2008...

Conference Delegate €640 + VAT @ 16% = €742.40
Students* €465 + VAT @ 16% = €539.40

(*Postdoctoral Fellows and Graduate Students qualify as trainees. Please provide a supporting email or letter from your PDF supervisor stating that you are 1) a fellow is within 5 years of completing their PhD (or equivalent) degree or 2) a student is registered in a graduate research degree program)

Please send me information on exhibiting and sponsorship opportunities at the Conference.

Payment Details

Total payment required €:
Please charge my Visa/Amex/MasterCard (Delete as applicable)
Card No.: Expiry Date: Today's Date:
Name & Address of Cardholder if different from above:
Name: Address:

DECLARATION (Please note that unsigned forms cannot be accepted) I have read and agree to abide by the payment and cancellation terms, and I understand that this form confirms my conference booking. I accept that from now on charges will be imposed for cancelled registrations, and that up to the full registration fee will be payable if I am unable to attend the conference for any reason.

 

Signed:__________________________________________________________________

Date:__________/__________/__________

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