Registration form (2/3)

Olivier Troccaz, lundi 30 mars 2009 - 12:56:57

No Longer Supported
Civility
Mrs.
Ms.
Mr.
First name No Longer Supported
Family name No Longer Supported
Laboratory/
institution
No Longer Supported
Code UMR No Longer Supported
SIRET number No Longer Supported
Postal address No Longer Supported
For all participants, registration fees include: Conference documentation, the welcome reception on May 17, coffee and lunches according to the program and the Conference dinner (Banquet) on May 19.
Email No Longer Supported
Telephone No Longer Supported
Fax No Longer Supported
Status
Student
Regular
Invited speaker
For student, a document testifying student status must be provided with the payment of the registration fees.
Excursion Normandy (information will be available soon)
Number of eventual accompanying persons :
Welcome cocktail (18 € / person) No Longer Supported
Conference dinner (54 € / person) No Longer Supported
Excursion (TBA soon) No Longer Supported


Payment
Bank Check
(French accounts only): can be sent to the benefit of “Agent Comptable du CNRS Bretagne et Pays de Loire"
Bank transfer
to: “Tresor Public de Rennes” To the benefit of “Agent Comptable CNRS DBPL Rennes IBAN: FR76 1007 1350 0000 0010 0470 876 SWIFT/BIC: BDFEFRPPXXX"
Order form
(Bon de commande French only) To CNRS UMR 6553, N° division CNRS 0935, Adresse : Sandra Rigaud, Bât. 14A Campus de Beaulieu, 35 042 Rennes Cedex, SIRET 18008901303365
Credit card
Please download the form from the following link, and send the scanned signed copy by email to -email- or the original by post to Sandra Rigaud, UMR CNRS 6553 Université de Rennes 1, Bât. 14A Campus de Beaulieu, 35042 Rennes Cedex (France).
Other remark No Longer Supported