REGISTRATION FORM
WORKSHOP |
| (Please circle) |
IEEE MEMBER |
Non Member |
| ADVANCE REGISTRATION
(before 1 September 2000) |
450 Euro |
500 Euro |
| LATE/ON-SITE REGISTRATION
(after 1 September 2000) |
500 Euro |
560 Euro |
|
TUTORIAL |
| (Please circle) |
| 250 Euro |
| 300 Euro |
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| IEEE N°: | __________________________
Use BLOCK CAPITALS
| Last Name:
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| | First Name:
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| | Organisation:
| ______________________________________________________________
| | Address:
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| ______________________________________________________________
| | Country:
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| Tel. N°:
| __________________________
| Fax N°:
| __________________________
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| E-mail:
| ____________________________________________________________
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| Author:
| yes 
no
| Session N°:
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They are 3 ways to pay the registration fee (tick one):
by cheque or bank transfer:
Payment to Madame l'Agent Comptable Secondaire du CNRS, Délégation Alpes,
CNRS, 25, avenue des Martyrs, BP 166X, 38042 GRENOBLE Cedex, FRANCE -
by cheque or bank transfer to the following account number:
Bank: TRESOR PUBLIC Grenoble 10071-38000-00003000056-07, mentioning THERM2K-B0706
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by credit card (SA UNIVAL):
Visa Card
Mastercard
Eurocard
American Express
Diners
| Credit Card N°
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| Expiry Date:
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| Name of Cardholder: . . . . . . . . . . . . . . . . . . .
| Total in Euro: . . . . . . . . . . . . . . . . . . .
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Date / Signature:
on site: payment will only be accepted with credit card payment in Euro.
The Workshop registration fee includes the lunches on 25, 26 and 27 September, the dinner on 25 September, the banquet on cruising ship on 26 September, the coffee breaks and a copy of the informal Proceedings.
A cost of 55 Euro will be charged for accompanying persons for the dinner on 25 September and for the banquet on cruising ship on 26 September. If you require, please indicate the number of accompanying persons and add the corresponding amount to the payment:
accompanying persons at the dinner on 25 September and the cruising ship on 26 September.
tick here if you wish vegetarian meals.
The Tutorial registration fee includes the lunch on 24 september and a copy of the hand-outs.
Refund policy for preregistration: there is a 31 Euro service charge for processing refunds. Requests for preregistration refunds must be received no later than 7 working days prior to the first day of the Workshop to be honoured. No refunds will be issued after 14 September 2000.
Substitutions will be accepted at any stage.
The form is to be returned to:
THERMINIC Workshop
TIMA
46, avenue Félix Viallet
38031 GRENOBLE cedex 1
FRANCE
Fax: +33 4 76 47 38 14