WORKSHOP REGISTRATION FORM
WORKSHOP
(Please circle) IEEE MEMBER Non Member
REGISTRATION (after 1 September 2001) 500 Euro 560 Euro
TUTORIAL
(Please circle)     A   or   B  
300 Euro
IEEE N°:__________________________                                   Use BLOCK CAPITALS
Last Name: ______________________________________________________________
First Name: ______________________________________________________________
Organisation: ______________________________________________________________
Address: ______________________________________________________________
______________________________________________________________
Country: ______________________________________________________________
Tel. N°: __________________________ Fax N°: __________________________
E-mail: _______________________________________________________________
Author: yes   Cadre           no   Cadre Session N°: Cadre

They are 3 ways to pay the registration fee (tick one):

  Cadre    by cheque or bank transfer:
Payment to Monsieur 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:
    TRESOR PUBLIC Grenoble 10071-38000-00003000056-07, mentioning T1-B0706

  Cadre    by credit card (SA UNIVAL):

        Cadre Visa Card     Cadre Mastercard     Cadre Eurocard     Cadre American Express     Cadre Diners
Credit Card N°
















Expiry Date:




Name of Cardholder:   . . . . . . . . . . . . . . . . . . . . . . . . . Total in Euro:   . . . . . . . . . . . .

  Date / Signature:

  Cadre    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 cocktail on 25 September, the banquet 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 banquet on 26 September. If you require, please indicate the number of accompanying persons and add the corresponding amount to the payment:
  Cadre     accompanying persons at the banquet on 26 September.
  Cadre     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 50 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 2001.
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