ISTU 2009 - Aix en Provence - Individual registration form
INDIVIDUAL REGISTRATION FORM
IN CAPITAL LETTER
1. PARTICIPANT INFORMATION FOR CONFIRMATION & SYMPOSIUM DOCUMENTS


Family Name    First Name 
         
Organization    State / Prov 
         
Address    Zip code 
         
City    Country 
         
Email    Phone Number 

All fields required

2. BILLING ADRESS
Company    VAT Number 
         
Address    State / Prov 
         
City    Zip code 
         
Country    Email 

All fields required except VAT Number

3. REGISTRATION FEES IN EURO

The price indicated en Euro is only applicable if both registration AND payement are received before the deadlines.

  Up to 11.05.2009 15.06.2009 From 11.05 15.06 to 07.09.2009 ON-SITE
Standard fee (includes dinner) 500 Euro
Student (includes dinner) 300 Euro
One-Day ticket
(no dinner included)
  

Sept. 24-25

Sept. 25-26

250 Euro

250 Euro
Gala dinner, Sept. 25
   95 € per ticket
Nb of tickets    
Conference fees : 0 € + Gala dinner : 0 € = TOTAL : 0 €

4. PAYMENT IN EURO

Credit Card (EuroCard, Master Card, Visa)

 

Cheque in Euro made payable to SuperSonic Imagine
Send to: SuperSonic Imagine - ISTU 2009
Les Jardins de la Duranne - Bât. F - 510, rue René Descartes - F - 13857 Aix-en-Provence Cedex

Cheque Number