THERMINIC'04

WORKSHOP REGISTRATION FORM
Workshop advance registration and tutorial advance registration is applied if participant is registered and the payment is received before 27 August 2004.
Fields in RED are mandatory.
WORKSHOP
Registration
IEEE member/CS Member/Author/Committee Member: Yes No
IEEE N°:
Session N°:
IEEE member/CS Member/Author/Committee member: 450 €
No IEEE member/CS Member/Author/Committee member: 550 €
TUTORIAL
Registration		 Yes No
250 €
Workshop registration fee covers admission to all sessions, the exhibition, coffee breaks, the cocktail, the dinner, and the Workshop proceedings. Tutorial registration fee covers admission to the tutorial on 28 September and documentation.
  Mr       Mrs
Last Name:
First Name:
Organization:
Address:
 
City:
State:
Zip Code:             Country:  
E-Mail:
Phone No:
Fax No:
There are 3 ways to pay the registration fee(tick one).
by cheque or bank:
    Please send evidence by fax to : +33476473814, attention to Bernard COURTOIS
  • payment by cheque to:
    Monsieur l’Agent Comptable Secondaire du CNRS, Délégation Alpes, CNRS
    25, avenue des Martyrs
    BP 166X
    38042 GRENOBLE Cedex
    FRANCE
  • payment by bank transfer to:
    Monsieur l’Agent Comptable Secondaire du CNRS
    Trésorerie Générale de l'Isère
    Account number: 10071-38000-00001000056-72
    IBAN: FR76 1007 1380 0000 0010 0005 672
    Swift code: BDFEFRPPXXX
    mentioning T4/C5159
  by Credit Card:
We do not recommend to send your credit card number to the internet. Please send a fax.
Fax number : +33 4 76 47 38 14,
attention to Bernard COURTOIS.

The Workshop registration fee includes the lunches on 29-30 Sept - 1 Oct the cocktail on 29 September, the social event on 30 September, the coffee breaks, and a copy of the informal Proceedings. A cost of 90 € will be charged for accompanying persons for the social event on 30 September and the cocktail on 29 September. If you require, please indicate the number of accompanying persons and add the corresponding amount to the payment: (0 = alone).
Accompanying persons at the social event on 30 September.
Tick here if you wish vegetarian meals.
Tick here if you not wish vegetarian meals.

Refund policy for preregistration: there is a 80€ service charge for processing refunds. Requests for preregistration refunds must be received no later than 6 working days prior to the first day of the Workshop to be honoured. No refunds will be issued after 20 September 2004. Substitutions will be accepted at any stage.